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Bethesda, Maryland 

Gift of 
The National Center for Homeopathy 






















also : J. T. S. SMITH, 592 Broadway. 

PHILADELPHIA: C. L. Rademacher. 

BOSTON: Otis Clapp. 

ST. LOUIS, Mo. : F. Franksen and C. F. WE3SELH(EfT 

LONDON : J. H. Balliere, 219 Regent-street. 




Entered, according to Act of Congress, in the year ]847, by 


In the Clerk's Office of the District Court for the Southern District of New- York. 


What has induced me to devote myself, for the last seven- 
teen years, to the study and propagation of the new doctrine, 
is not the love of system nor the spirit of party, but an intense 
conviction of its high worth. When after a practice of twenty- 
two years, I first commenced studying homoeopathy, it was yet 
very imperfect, but even then I saw very clearly that it would 
rise above the character of an empirical art, and would even 
take precedence over any of the existing medical doctrines. 
My gratitude for Samuel Hahnemann, the author of the new 
doctrine, has not allowed me, however, to close my eyes to its 
existing imperfections. To aid in removing them, has ever been 
my warm desire ; neither the contempt with which the thought- 
less partisans of Hahnemann seemed to look upon my effort to 
impart to their new doctrine a higher scientific character, nor 
the uncivil denunciations which the blind champions of the 
old dogmatism have hurled against the new doctrine, nor the 
insulting names with which its disciples have been reviled by 
authors and editors of medical journals, will prevent me from 
accomplishing my purpose. I have always endeavored to ac- 
quaint myself with every new advancement in the medical 
sciences, and claim therefore the right of expressing an opinion 
on the present character and standing of homoeopathy. I had 
hoped, but in vain, that some more able man, than I am, 


would arrange the existing materials into a more scientific 
system of therapeutics. The time has come when this should 
be done, both for the benefit of beginning practitioners who 
require a guide in the more thorough study of our doctrine, and 
in order to show to our vehement opponents, that discovered 
principles are superior to those, which have been excogitated 
by human ingenuity. I have called this work " Organon," not 
because I consider it the last development of homoeopathy, but 
simply because it is a record of my own views and experience. 
I am convinced that homoeopathy is capable of constant pro- 
gress, and consider it any body's right to proclaim to the world 
the result of his honest and earnest meditations. Truth be- 
longs to mankind, not to the individual man ; what he considers 
truth, it is his bounden duty to state. 

Giessen, August^ 1838. 




The highest object of medicine is to remove morbid phe- 
nomena, or, in other words, to restore health in the safest, quick- 
est and most pleasant manner. A medical doctrine is of no 
value except in so far as it fulfils that end. 

It is one of the characteristic features of our age to consider 
the usefulness of things, without paying any regard to the age 
of an institution, dogma or custom. It is not our purpose here 
to show that people often go too far in measuring the value of 
things merely by the material advantages which they procure. 
However, physicians would exhibit an untimely vanity if they 
would complain of having their knowledge and talent, and the 
value of their principles, critically examined, and of being 
asked, "What certainty have you? What guarantee do you 
offer that we will not be sacrificed to prejudice, or to the love of 
system, by confiding in you?" Questions like these have be- 
come much more frequent lately. Confidence in medicine has 
been destroyed by a blind party spirit; by the intolerance 
which one physician manifests towards another, and of which 
Hufeland remarked a few years previous : " Every doctor who 
loses a patient is accused of having killed him, by those who 
do not think as he does" In former times medicine enjoyed a 
higher consideration, and if a reproach was uttered, it was 
against the wrong application of the principles of the school in 
isolated cases, or against the boldness of those who had dared 
leave the beaten track, which was considered the only safe one. 


But now-a-days, the infallibility of a medical doctrine has be- 
come the subject of bitter satire; the contradiction which ex- 
ists between the different medical doctrines having no longer 
remained a secret. Physicians who are careful observers, and 
are not carried away by the spirit of faction, still enjoy the 
reputation of being intelligent and able men. 

I do not mean to say that systems have no value. We 
ought to look upon them as creations of a poetic ideality which 
are sometimes worthy of exciting our astonishment as works 
of art. Like brilliant stars, their object is to shed light on iso- 
lated observations, in order to unite them in one harmonious 
whole, and to guide us safely through the labyrinth of doubt 
and hypotheses. Systems should guide us in our practice, and 
their correctness should be measured by the means which we 
derive from the true application of their principles. 

It is a remarkable fact that the name of the great physician 
of Cos has remained an object of veneration for thousands of 
years past, during the period of conservatism as well as of re- 
form in medicine. Even the dogmatists, when at the very 
climax of their glory, have always spoken of the Hippocratic 
medicine with respect, and have never dared tarnish the glory 
of its author. It is not less remarkable that dogmatists, em- 
pirics, and eclectics appeal to him as an authority, although his 
greatest merit consists in teaching us the art of faithfully ob- 
serving the phenomena of disease. This is his greatest merit. 
His philosophy is a rational empiricism based upon experience, 
his rules of practice are derived from experience. Avoiding 
dogmatism, he has never tried to arrange the results of his ex- 
perience into a system. In his practice he was an eclectic, 
and had no other guide in the treatment of disease except his 
power of observing and individualizing it. 

A number of distinguished physicians, both ancient and 
modern, have taken him as their model in practice, and we 
may say that the most successful and the most celebrated prac- 
titioners have keptaloof from systems, and have been eclectics. 

In the course of time, however, the empirical treatment of 
disease became more and more difficult and uncertain, for the 
simple reason that the forms of disease are so various that 
even the oldest man could only become acquainted with very 
few of them by his own observation. The best memory is not 
able to hoard all the results of other people's observations, nor 
is it an easy business to distinguish truth from falsehood in 
that mass of relations of cures and pretended observations 
which are offered for sale every day. This is the reason why 
the most distinguished empirics are frequently greatly embar- 


rassed. In the absence of analogous observations, made either 
by themselves or by others, they are obliged to resort to an em- 
pirical treatment, which is often very doubtful in its results, or 
else they have to be guided by general rules of their own 
make. The necessity of analogous principles having been 
constantly felt, nothing is more natural than that attempts 
should have been made every now and then to establish the 
practice of medicine upon a solid foundation. 

Justice requires that we should recognize all the importance 
of the attempts which have been made for upwards of two 
thousand years to attain that end, and that we should honor 
with the deepest gratitude the memory of those physicians 
who have sacrificed fortune, health, life even, to the advance- 
ment of medical science. This is not the place to give a de- 
tailed account of their devotion, of the services which they 
have rendered to the collateral sciences, or of the different sys- 
tems of medicine : our object is to show in what manner we 
should proceed to reduce the rules of practice to scientific prin- 

To appreciate the new doctrine which it is the object of the 
present work to examine, we have to compare it with the spirit 
of the old school of medicine ; and, in order to enable our 
readers to accomplish that purpose, we shall, without entering 
upon any unnecessary details, furnish an account of the means 
which have hitherto been resorted to to cure disease. 

By merely casting a glance at history, we perceive that 
medicine has always progressed apace with civilization. We 
will not inquire whether chance or instinct has first made us 
acquainted with the medicinal virtues of certain substances in 
certain diseases. In the first ages of the medical art the know- 
ledge of remedies was evidently very imperfect, and the 
art of curing consisted merely in administering certain reme- 
dies which had been found efficacious in certain cases, when- 
ever similar cases should occur again. This was gross empi- 
ricism, based exclusively upon a superficial comparison of the 
external symptoms of disease, and adapted only to the infancy 
of humanity. When the human mind had been more de- 
veloped, man began to reflect on the first causes of the phe- 
nomena of nature — on the modifications which they undergo. 
In medicine, attempts were made to establish a rational mode 
of treatment, the fundamental principle of which was to re- 
move the cause of the disease, and, in this way, to cure the 
disease itself. 

The principle, " tolle causam" has been followed until this 
day, and has only been objected to by some upon the ground 


that the cause, being in most cases hidden from our senses, can 
only be discovered by speculative reasoning. In such a case, 
it is easy to fall into errors ; every author of a new system has 
endeavored to guard against errors, and all have succeeded 
more or less, but none of them entirely. 

Inasmuch as at an early age even, the phenomena of dis- 
ease were considered manifestations of an anormal vital force, 
this view necessarily led physicians to reflect on the vital force 
itself, and to ascend to the causes of the perceptible phenomena. 
Henceforth medicine became subject to the influence of philo- 
sophy, as every one may see by looking at the philosophy of 

The philosophy of that age was a daughter of poesy ; and 
a great portion of it had remained poesy. Hence it was more 
convenient to imagine than to discover principles, for this ad- 
ditional reason, that the physical sciences were still in their 
infancy, and therefore unable to furnish to speculative science 
reliable points of support. In the absence of such points any 
attempt to discover the first principles of things, must necessa- 
rily lead to fanciful speculation. It has been frequently asserted, 
on this account, that medicine cannot gain any thing from its 
alliance with philosophy. This assertion is only true, how- 
ever, if one confounds a principle invented by human ingenuity 
with a fundamental truth, and adopts such speculative princi- 
ples as the highest rules in practice. Philosophers have never 
succeeded in discovering the first principle of life, and in lifting 
the veil which covers the mysterious existence and nature of 
the soul. Pythagoras and Plato have shown a good deal of 
ingenuity by considering the play of the vital forces as a cir- 
cular or elliptical movement, or as an oscillation between the 
two extremities of a line ; but their philosophy has not ad- 
vanced medicine a single step ; and however beautiful and in- 
teresting their speculative reasonings may appear, they have 
so far been of no sort of avail at the bed-side of the patient. 

This is not the place for entering upon a critical examina- 
tion of the different systems of philosophy, most of which 
have, in times past, been mere repetitions of the philosophy of 
Plato and Aristotle, or attempts to conciliate these two thinkers, 
the former of whom has become the leader of the spiritualists, 
whereas the latter has devoted his efforts to the defence of ma- 
terialism. It may be said in general terms, that mere specu- 
lative reasoning has had very little influence on the natural 
sciences and on medicine. Abstract reason is sufficient to es- 
tablish the general necessity of certain phenomena, but it re- 
quires real, positive observations to substantiate speculative 


doctrines. The idealists neglect too much the slow and labo- 
rious process of observing phenomena to investigate their first 
cause by means of analogy, to derive general laws from facts, 
and gradually to rise from the lower to the higher. 

The analytical method is another system of philosophy, 
without which there can be no rational medicine, and which is 
at once more practical and more fertile in results. The object 
of (he analytical method is not to lose itself in speculations 
about the essence of things, but to observe the changes which 
take place in the phenomena, and to avail itself of individual 
observations for the purpose of arriving at a knowledge of the 
causes by sound logical conclusions. 

The gigantic steps which have been made in the natural 
sciences invite us to arrange the facts obtained under a general 
law and to trace them to their cause. Analysis and specula- 
tion are both busy in accomplishing that work. He who is 
animated by the desire of attaining a higher degree of know- 
ledge, must be rejoiced to see so many men engaged in culti- 
vating it. It is probable that we shall never arrive at a perfectly 
satisfactory solution of the problems of nature ; but the better 
we succeed in accounting for the various manifestations of vi- 
tality, the better we shall be able to restore health. 

What is more particularly in the way of progress, are the 
multiplicity of the questions which the study of the unity of 
all the natural phenomena suggests, and which have so far re- 
mained unanswered, and a tendency inherent in our minds to 
study in one direction only. Even in pursuing the analytical 
method, we are led to select among the great mass of Natural 
phenomena some as more particular objects of inquiry, and to 
establish laws as general, which are not so in realj'y^ Unwill- 
ing to give up a favorite idea and obliged, on the other hand, 
to demonstrate the pretended truth of a theory, the mind 
plunges into a labyrinth of sophisms based upon premises which 
are so false that it is sufficient to break down a single one of 
them, to overthrow the whole structure. 

Thus we see how dangerous it is to generalize too soon or 
too much, whereas by a careful individualization, and an im- 
partial examination and observation of isolated phenomena 
we shall discover their fundamental laws in the surest manner, 
and at the same time become convinced that general principles, 
without losing anything of their generality, are frequently 
obscured by apparent exceptions. 

In considering these different methods, we shall be able, 
without much trouble, to account for the various systems of 
medicine. They all have a common end, which is to remove 


the known causes of disease ; or, in other words, to apply a 
rational treatment; but they differ in regard to the means 
which the spirit of inquiry has pointed out as the most proper 
to attain that object. Idealism and empiricism govern in med- 
icine as in philosophy. The former, starting from a precon- 
ceived idea of the moving forces of things, inquires particularly 
into their invisible and occult qualities, and loses itself in fruit- 
less attempts to account by general cosmic principles for the 
numerous forms of individual life. 

Recognizing the difficulty, or rather the impossibility of 
constructing a practical therapeutic system in accordance with 
the vast conceptions of the idealists, the partisans of rational 
empiricism have simply endeavored to elevate medicine to the 
rank of an experimental science. 

Huts and houses have been built, and bridges constructed, 
long before any one thought of writing a systematic treatise on 
architecture. In a similar manner the materials of a special 
therape'ia had first to be collected before it was possible to com- 
pare them with one another, to deduce from them the condi- 
tions of similar or analogous phenomena, and to establish the 
principles of a general therapeia by logical reasoning. This 
route, however, does not lead to the discovery of a system 
which is based upon a knowledge of the fundamental princi- 
ple of life. Our knowledge is, in a great measure, fragmentary. 
Even those branches of medical science which have been cul- 
tivated with the greatest care — osteology and the anatomy of 
the soft parts— are still imperfect, and are enriched every day 
with new discoveries. Physiology is still less perfect. We 
do not yet possess an accurate knowledge of the structure of 
the organs^ we are still less acquainted with their importance 
and their functions. The majority of the most important phe- 
nomena, nutrition and sanguification, are still mysteries for us. 
and our knowledge of the sympathetic relation of a great num- 
ber of organs is still very incomplete. 

Pathology is based upon physiology, because we require 
to know the laws of the vkal functions in their normal condi- 
tions, before we can obtain <x clear notion of their anormal 
changes. In considering the narrow limits of our physiologi- 
cal knowledge, we will not be astonished at the obscurity of 
pathology, and the vagueness and uncertainty of our thera- 
peutic principles will at once become manifest. This uncer- 
tainty is denied, it is true, by a great wimber of physicians, 
particularly by those narrow-minded practitioners who accord 
an unlimited faith to the text-books and lectures of their 
teachers, and who, under the cloak of those authorities, think 


of nothing more sedulously than of obtaining a large practice; 
or perhaps by those who have too high an opinion of their 
own wisdom, to admit that the splendor of medicine is dark- 
ened by extensive spots. On the other hand, a number of dis- 
tinguished practitioners and celebrated writers, have com- 
plained of the imperfections of our science, and have shown 
that those who know most, feel them most keenly. The ad- 
missions of such men ought to convince us that every thing 
which has been accomplished hitherto on the field of science, 
bears the impress of imperfection. Nevertheless, we ought 
not to despise the efforts which have been made, howso- 
ever unsuccessful, to enrich our knowledge, and we ought to 
admit that science gains something by all these attempts at 
establishing order among its phenomena. The zeal of those 
who cultivate it, will be reanimated by publishing that which 
is still wanting. 

Objective perceptions which constitute, properly speaking, 
the foundation of our knowledge, have first revealed to us the 
existence of certain anormal modifications in the material 
sphere of the sick organism, such as general or topical atrophy 
or hypertrophy, swellings, boils, nodosities, ulcers, blotches, 
vesicles, rhagades, exanthemata of every kind, changes in the 
color of the skin of certain parts of the body, increase or de- 
crease of animal heat, a greater or lesser quantity of sweat than 
usual, or changes in the character of the sweat, gaseous exha- 
lations, changes in the breath, tears, nasal or buccal mucus, 
saliva, cerumen, alvine evacuations, urine, semen, mucus of 
the urethra and vagina ; morbid appearances in the blood, par- 
ticularly the menstrual blood, in the milk, lochia, etc. Post- 
mortem examinations have revealed to us more or less general 
changes of structure, an irregular development and position of 
certain organs, pseudo-membranes and filaments with unnat- 
ural adhesions, interstitial distentions and softenings, complete 
changes of substances, indurations, concretions, ossifications, 
obliterations, dilatation of vessels, irregular formation of new 
vessels, internal swellings and excrescences, polypi, funguses, 
tubercles, effusions, etc. 

By an examination after death, we have even discovered 
changes in the quality of the blood, bile, pancreatic juice, intes- 
tinal mucus, and other fluids. 

By means of chemistry we have discovered different pro- 
portions in the composition of the tissues, and all these facts 
have been made use of to explain morbid phenomena. It has 
been for a long time supposed that disease depended on mate- 
rial changes in the organism. It is undoubtedly true that essen- 


tial changes in the material tissues which are the substratum 
of the vital forces, must occasion differences in the manifesta- 
tions of those forces. 

The physicians who incline to materialism, have divided 
themselves into two classes, the iatro-j)hy steal (mechanical) 
and the chemiatrical (chemical) school. The former school 
considers simply the structure of the parts representing the bones 
as the superstructure, the muscles as so many levers, the heart 
as a sucking pump or a compressing apparatus, the small ves- 
sels as sucking tubes or a filtering apparatus, &c. According to 
the mechanical school, disease is occasioned by derangements 
in the machine, it leaves the motor force out of all consideration. 
The influence which that school has had in medicine, has 
been more sensibly felt in physiology and pathology than in 
therapeutics ; and even at this moment, when such great im- 
provements have been made in the physical sciences, particu- 
larly in the study of electricity, galvanism and magnetism, the 
modes of the mechanical school are resorted to, to explain in a 
more or less satisfactory manner any phenomena of vitality. 
In a most ingenious manner the vertebral column has 
been compared to the pile of Volta, the nerves to the conduc- 
tors of the fluid, and the secretions have been considered re- 
sults of the effects of a closed galvanic chain. This solution 
of the problem of vitality is, however, too little satisfactory to 
promise great advantages to the science of curing disease. 

The chemical philosophers have only considered the com- 
position of the substances constituting the organism. They 
are divided into solidists and humoralists, the former of whom 
consider the solids as the primary sphere of the probable 
causes of disease, the latter the fluids. The solidists are more 
nearly related to the mechanical philosophers. Humoral pa- 
thology rests upon the supposition that all organized bodies have 
gradually developed themselves out of liquids by a process of 
crystallization and condensation, and that the solids of the 
human body are derived from the fluids. They have simply 
forgotten, however, that forms, whether they belong to the spe- 
cies, the variety, or the family, are subject to the mysterious 
action of the vital force which causes the oak to spring from 
an acorn and not from a coffee-bean, the eagle from an eagle's 
and not from a goose's egg, or the rhinoceros from his like and 
not from a goat. They have forgotten that these organized 
fluids are the products of the activity of the secretory vessels, 
and, that the deterioration of the fluids must therefore be owing 
to a more deep-seated cause. The idea, that disease resulted 
from an alteration of the fluids, had become so fascinating, that 


a system of pathology and therapeutics was constructed in ac- 
cordance with it, the only object of which was to expel the 
vitiated humors, and to correct those which could not be re- 
moved, by means of chemical remedies. A glance at the his- 
tory of this doctrine shows us a heap of hypotheses to which 
Anaxagoras and Gallienus, Erasistratus and Aetius have con- 
tributed. Sylvius de la Boe was the first who attempted to 
write a systematic treatise of humoral pathology ; he may 
therefore be considered the founder of that school. Alternately 
defeated and triumphant, his doctrine has found opponents and 
partisans, even in our time. 

We shall not deny that the humors have some claim to our 
attention, and that they occasion pathogenetic effects in the 
organism (unlike Fernelins, for instance, who asserts that the 
fluids should not be considered as belonging to the organism) ; 
but to consider them the primary cause of disease, appears to 
us a sad return to materialism, which has unfortunately found 
a number of partisans at the present time. 

It was reserved to the genius of George Ernest Stahl to 
found a new school, the dynamic school, which studies princi- 
pally the motor force in the organism. According to the dy- 
namists, it is this force that produces all the organic and func- 
tional changes in the organism. This is not the place to in- 
quire whether Stahl is the only author of that system, or whe- 
ther the idea has been suggested to him by Van Helmont, 
Perrault, Descartes, etc. Nor does it matter whether Stahl's 
idea of the soul being the first cause of all organic activity, is 
really new, or whether the tvoQfxov of Hippocrates, the archaeus 
of Van Helmont, or vital force or principle, is the same as 
Stahl's soul. 

But he, as well as a number of his partisans, has made 
himself liable to the charge of having, like other schools, view- 
ed the matter only from one side. For a long time one had 
endeavored to account for all physiological and pathological 
phenomena by arguments drawn from the organic structure 
and composition of the humors. The school of Stahl did ex- 
actly the contrary, and without any more reason ; it viewed 
the active, moving, modifying force in the organism as an ab- 
straction ; as if that force could act and move in the organism 
independently of its material forces. 

By giving one's self up to the doctrine of the vital forces, it 
became impossible to avoid falling into a multitude of sophisms 
and extraordinary hypotheses. It is not our intention to dwell 
upon them here, contenting ourselves with merely mentioning 
the purely dynamic system of Brown, the foundations of which 


had been laid by Louis Roger* more than a century before, 
who taught that irritability is only a disposition or property by 
means of which the vital force is enabled to manifest itself, but 
that irritability is not the only and sufficient cause of those 
manifestations. This was Brown's explanation of life, who 
considered incitability the internal, and the surrounding world 
the external factor of the vital force. 

This system commended itself by its simplicity to unexpe- 
rienced physicians and laymen. For a long time it had a num- 
ber of partisans, and would have lasted much longer, if its no- 
sology had been more conformable to experience, and if a want 
of success in the treatment of disease, agreeably to Brown's prin- 
ciples, had not made their falsehood evident. According to Brown, 
every disease resulted from an excess or deficiency of vital ac- 
tion ; hence he arranged all diseases under two general heads. 

Brown's system gave rise to that of Broussais, who, starting 
from a similar principle, considers every disease as one of local 
irritation. It is from this position that all his therapeutic prin- 
ciples were deduced — those enormous depletions, and that mon- 
strous vampyrism which posterity will look upon as one of the 
great errors of our age. 

Another modification of the theory of irritation is the doc- 
trine of counter-stimulation by Rasori, who, like Brown, ad- 
mits only of two principal forms of disease opposed to one an- 
other: excessive, or deficient activity, representing the ancient 
striclum and laxum— contraction and relaxation. The treat- 
ment which has been deduced from this principle, consists in 
administering large doses of remedies supposed to be contrary 
to the disease. These remedies have been divided into two 
classes in the most arbitrary manner, and which is by no 
means justified by experience. In spite of the apparent har- 
mony of this system, it could not be expected that it would ac- 
quire any considerable influence ; the poverty of that system 
was too apparent, and the spirit of our age is totally averse to 
speculative theories, and requires solid arguments to accept a 

Brown's system and the theory of irritation to which it 
had given rise, had given a new impulse to speculation, and 
had furnished a most favorable opportunity for the construction 
of a system in accordance with the dictates of the philosophy of 
nature, which was based upon the supposition that the general 

* Specim. physico-logic. de perpetua fibrarum muscularium pal- 
pitatione, novum phaenomenum in corpore humano, experiments de- 
tectum et continuatum. Gottiner. 1660. 


laws of the universe controlled the existence of every single ob- 
ject, and that we must resort to pure leason, in order to discover 
the therapeutic method which is harmonious to those laws. 
This system is dynamic in its character, since its fundamental 
idea is that of force, by means of which the perceptible phenom- 
ena of life are accounted for ; this system is less incomplete than 
most other similar systems, inasmuch as it does not omit the 
material sphere of the organism, and recommends particularly 
the analytical study of the organs ; practical medicine however 
has not yet derived any advantage from that system. 

No one will deny that the pathological alteration of the or- 
gans, which we are bound to consider the vehicle of the vital 
forces, must necessarily modify the manifestations of those 
forces. But in spite of the light which the physical sciences 
have shed on the dynamic action of things, a retrogradation to 
the grossest materialism evidently threatens pathology, since 
anomalies in the formation and composition of tissues are mis- 
taken for the essential principle and cause of disease ; as though 
those anomalies could exist independently of the reproductive 
vital force, and as though they could be any thing else than 
mere products of an anormal activity. There are pathologists 
who are on the point of overlooking the existence of a vital 
activity, and reject almost every thing which they do not either 
see or hear. Stethescope, plessimeter, and microscope, are their 
surest means of diagnosis, and there are physicians now-a-days 
who know more about the movements and the covering of the 
blood-disks, than about the mode in which morbid conditions 
develope themselves. The great use of pathological anatomy 
cannot be doubted*, we should guard, however, against attach- 
ing too much importance to it. 

In the course of a great number of diseases, material modi- 
fications take place, which make us indeed acquainted with 
the course the disease has taken, but do not reveal to us 
the principle and cause of the disturbance ; hence it is that 
pathologists are all the time disputing about the fact, whether 
certain organic anomalies are the result of inflammation, or 
the product of a primarily disturbed, reproductive activity. 
Such anomalies are : softenings, relaxations, dilations, strictures, 
obliterations, hypertrophies, tubercles, indurations, etc. To 
this class belong likewise the intestinal ulcers, which some be- 
lieve to be the origin, others the result of typhus abdominalis. 
Alterations are frecmently discovered in bodies, which have 
taken place after death. I may mention the coagulation of 
the blood in the heart and the aorta, which has given rise to 
many errors, the watery effusions in the brain, after a fatal 


stroke of apoplexy, and the changes of color which are ob- 
served in internal parts, the red appearance of which is not 
always a proof of inflammation, as has been sufficiently shown 
by the observations of Rapp [ and Yelloly. 2 The absence of 
redness, according to Rapp, is, on the other hand, just as un- 
certain a proof of the absence of an inflammatory disease, par- 
ticularly in the intestines, since the discoloration may have 
been occasioned by certain gases, such as the sulphureted 
hydrogen gas. 

Our knowledge of the modifications which the substance 
of the organs undergoes in disease, is as yet very imperfect. 
We know as little of the changes of the blood and humors, and 
we cannot help being astonished at the boldness with which 
the imperfect and often contradictory results of the investiga- 
tions which have been made until this day, and which are 
mixed with a great number of hypotheses, have been considered 
by some physicians as proofs that the anomalies in the compo- 
sition of the humors are the primary causes of disease. 

In investigating the causes of the alteration of the humors, 
the attention of pathologists has first been directed to the blood, 
inasmuch as it contains the substance which serves to develope 
the organism ; for no one can deny that the composition of the 
blood and of the humors is liable to various, sometimes import- 
ant modifications. For a long time past it has been admitted 
that the blood of scorbutic and chlorotic patients contains an 
excess of serous particles, and is deficient in fibrin ; and that 
the blood of pregnant women contains an excess of coagulable 
lymph. Witt stock has discovered in the blood of cholera pa- 
tients a diminution of from one to seven per cent, of fibrin, 
which was, moreover, less white when washed, than that of 
the healthy blood. He has, moreover, discovered in the right 
ventricle a blood resembling tar, and mixed with polypous 
coagula. According to Jennings, the blood of arthritic pa- 
tients contains an excess of phosphoric acid and azotic sub- 
stances. According to Stevens, the blood of yellow fever pa- 
tients is deprived of its saline particles. According to Andral, 
the blood becomes more copious in inflammatory fevers ; and, 
according to Scudamore, it contains three times more fibrin 
and less saline particles. In a patient affected with pulmo- 
nary phthisis, who was bled when the disease had reached 

1 Regis Guilielmi festum natalitinnTdie 27 Septemb. indicit rector 
et senatus Tubigensis; prgemittuntur annotat. pract. de vera interpreta- 
tione observationum anatomise pathological. Tubing. 1834. 

2 London Med. Gaz. Decemb. 1835. 


a high degree of development, and the patient was as pale as 
death, Zaccarelli observed that the blood had the color and 
odor of milk. Sion made a similar observation in the case of 
a man who was bled on account of a profuse hemorrhage from 
the nose and mouth, with tumultuous movement of the heart, 
anguish and want of breath. Carswell says that he has never 
seen tubercles without a morbid condition of the blood. Many- 
other similar observations furnish such convincing proofs of the 
alteration of the blood, that its existence cannot reasonably be 
doubted. Nor will the correctness of these observations be 
doubted by the dynamists or by the solidists : as regards the 
difference of opinion between the latter and the humoralists, it 
is simply this, whether the changes in the composition and co- 
hesion of the blood are the immediate consequences of external 
causes, or whether they have been occasioned by the instru- 
mentality of the vital force. 

The organism obtains the materials for its reproduction 
from the surrounding world by means of the stomach, the re- 
spiratory organs and the skin. The transformation into blood 
of the substances which have been introduced into the stomach, 
is principally effected by the process of chylification, which is 
therefore a secondary act, inasmuch as it presupposes the vital 
activity of the digestive organs. The alteration which occurs 
in the blood by the admixture of heterogeneous particles, may 
take place by a shorter route, by the almost evident absorption 
of the capillary vessels in the intestinal canal, the lungs and 
skin. Contagious diseases invade the organism most piobably 
by the two latter avenues. But if this absorption simply 
took place in accordance with the principles of hydraulics, 
independently of the vital force, it ought to continue under any 
circumstances. If we consider, however, that the reception of 
the contagium into the organism by either of the aforesaid 
ways, implies the necessity of a certain predisposition or adap- 
tation of the organism; if we consider that a great number 
of individuals, owing to the energy of their vitality, can ex- 
pose themselves to the most pernicious influences without 
being infected, and that they remain free from typhus or yellow 
fever in the midst of the Pontinian marshes, and at Havana 
as well as in New-Orleans; that others can touch patients dy- 
ing of the pest ; that others again are never infected with 
the syphilitic virus even in the midst of the most licentious 
intercourse with prostitutes, we cannot admit that absorption 
takes place in accordance with physical laws as liquids ascend 
in capillary tubes, or that the introduction of the contagium 
into the blood and the corruption which takes place in this 



fluid are chemical processes. On the contrary we are obliged 
to look upon these changes as true vital functions, and to sup- 
pose that the fundamental condition of their occurrence is a 
disturbance of the vital forces. The breath of an individual 
affected with a contagious disease, is sometimes sufficient to 
communicate it, and to call out instantaneously morbid pheno- 
mena. It is less possible to admit, that the mass of blood can 
be primarily altered with the rapidity of lightning by a contact 
with the imponderable contagium, than that the vital force can 
be suddenly disturbed by means of the nerves, of which dis- 
turbance the reproductive sphere particularly offers many in- 
stances. Fright, for instance, may occasion such a sudden 
change, by means of the nervous system, in the condition of 
the nurse's milk, that the infant may be thrown into convul- 
sions. The difference of the blood in the different periods of 
fever, is a still more striking proof of the fact that the altera- 
tion of the blood is a secondary effect of a primary disturbance 
of the vital forces. According to Jennings the blood flows 
slowly in the first period ; it is of a dark color, coagulates ra- 
pidly, and forms a thick coagulum of a dark color. In the 
second period, the blood flows more rapidly, does not coagu- 
late as rapidly, and forms a more solid coagulum which is some- 
times of a lighter color. In the third period, at the stage of 
collapse, it flows very rapidly, is of a watery consistence, dark, 
and coagulates imperfectly. It is well known that the blood, 
according as it is drawn at different periods, forms a coat which 
is more or less thick, or does not form any. 

A good deal of importance has been attached to observa- 
tions which have been frequently repeated, that the substances 
which have been introduced into the blood, are discovered in 
the secretions. Pereira has given us a large collection of such 
observations. A great number of experiments, however, have 
shown, that these substances cannot be discovered in the blood. 
Schnurrer says, that the blood develops in a latent manner 
every thing which penetrates it by the lymphatic vessels and 
the absorbents, and compares, with much ingenuity, the secre- 
tory organs to prisms decomposing the ray into its primary 

Some observations seem to show that substances may 
be introduced into the circulation without undergoing a total 
change. The Courier of New- York* for instance, relates the 
case of a man who had drunk two gallons in five days, and 
whose blood took fire when a match was held to it, and burnt 

* See Froriep's Notes, Vol. XL VIII., No. 4. 



for half a minute with a bluish flame. This does not show, 
however, that the alcohol was mixed with the blood without 
having undergone any alteration. It is very probable, on the 
contrary, that some modification had taken place, and that an 
inflammable hydrogen gas had been formed. All attempts to 
inject medicinal or heterogeneous substances into the blood have 
shown that the most violent and sometimes the most danger- 
ous reactions ensue. As similar reactions have not been 
observed in cases where, according to Herr, the most divers 
substances which had been introduced into the stomach are 
said to have been discovered in the blood, such as iodine 
hydrothionie acid, prussic acid, turpentine, oil of dippel, rhu- 
barb, etc., one is entitled to doubt the correctness of those ob- 
servations, and to believe that those substances which had 
become latent in the blood, were not so much educed as pro- 
duced by the chemical analysis. 

A certain corelation between the composition of the blood, 
the fluids and the things which are introduced into the stomach, 
cannot be denied. It cannot be denied, for instance, that per- 
sons who are badly nourished have poor fibrin, or that the 
organism may be saturated with certain substances, such as 
mercury, kali, logwood, which tinge the bones and even the 
teeth. But all these changes do not show that the blood is 
primarily diseased. The change in the "quality of the blood 
depends rather, 

1. Upon an insufficient absorption of the necessary sub- 

2. Upon an anormal secretion of substances which are 
component parts of good blood, and which should therefore not 
be separated from it. 

3. Upon a disturbance of the secretory and excretory 

These causes, admitted by Herr, of the morbid alteration 
of the blood, show that it arises from a disturbance of the vital 
forces, and we know that the disorder can only be removed by 
regulating the vital functions, and not, as has been supposed, 
by means which restore the normal proportion of the ingredi- 
ents agreeably to the laws of chemical affinity, in the same 
way, for instance, as alkalies are neutralized by acids. The 
difference between the solidists and humoral ists is one of 
opinion merely, for in practice they follow pretty much the 
same methods, although they explain the action of the remedies 

An attempt has been made to class the phenomena of life 
under three distinct heads, formation, motion, and se?i$ation, 



and for these different manifestations of vitality, different fun- 
damental forces have been admitted : reproduction as the prin- 
ciple of formation ; irritability as the principle of motion ; 
and sensibility as the principle of sensation. These three 
principles have been looked upon as the primary factors of 
vitality. Their harmonious relation constitutes health ; disease 
arises from the inordinate influence of any one of them. As 
material representatives, or carriers of these primordial elements 
of vitality, three particular orders of organs are likewise dis- 
tinguished ; hence, also, three orders of diseases : those of the 
reproductive, irritable, and sentient sphere. 

Very few practitioners, however, have engaged in these 
speculations ; even the partisans of this system are not always 
agreed among each other, and yet they talk of diseases of re- 
production, iiritability and sensibility, with as much assurance 
as if the correctness of those distinctions and divisions could not 
be doubted, although it is sometimes impossible to derive the 
least practical advantage from them. 

The organs of the reproductive system are liable to dis- 
eases which do by no means show that the reproductive acti- 
vity is at fault, but that there is a disordered sensibility or irri- 
tability. A disturbance of the sensitive sphere is frequently 
perceived, by the disorder existing in the reproductive sphere ; 
a fright, for instance, causes vomiting or diarrhoea ; jaundice is 
excited by chagrin, etc. These, and a great number of similar 
observations show us such an intimate union between the 
three factors of vitality, that one feels tempted to admit with 
Gauthier, that the vital force of the organism is an unity 
manifesting itself differently, according as the form and 
structure of the organs are different, in the same way as the 
effects of electricity differ amongst each other, according as the 
bodies in which the electrical force is perceived, differ in form, 
matter, and density. Admitting that physiology has gained 
by such studies, we cannot, however, admit that special patholo- 
gy and therapeutics have gained as much. Who will deny 
the endless difficulties which we encounter in numberless 
cases of disease in determining which of the three systems, or 
which of their particular organs, has been primarily invaded? 
and who will deny that it is impossible to define the special 
therapeutic indications without resorting to empiricism? 

The vehement opponents of the specific method of treat- 
ment which has been cultivated with so much care and suc- 
cess for some years past, seem^ to overlook the uncertainty of 
their treatment in praising it in such extravagant terms, and 
designating it exclusively by the term rational, as if the spe- 


cific treatment did not merit that appellation. Upon beholding 
so much partiality, we are led to ask, What is rational treat- 
ment ? Rational means evidently " conformable to reason ;" 
rational treatment is a treatment the principles of which are in 
accordance with the knowledge furnished by pure reason. 
Would it not be wise to prefer principles which have been dis- 
covered by observing Nature's facts, to principles suggested by 
human ingenuity ? The opponents of the specific treatment 
forget, in their blind vehemence, that all our works on patho- 
logy and therapeutics are filled with contradictions, which can- 
not be otherwise, since the knowledge which we possess of the 
proximate causes and of the essence of disease, is derived from 
our individual perceptions which are liable to constant changes. 
Fever, rheumatism, inflammation, and such like terms, are in 
every physician's mouth, and yet physicians have not yet 
agreed on one definition of fever, among the many which have 
been offered, nor upon the essential difference existing between 
the different kinds of fever. Mention is indeed made of con- 
cealed fevers ; that is to say, fevers which are not fevers, and 
which do not come under any definition. The same remark 
applies 1© rheumatism. The seat even of rheumatism is as 
yet under controversy ; nor do physicians adopt the same 
mode of explaining the rapid ehanges of locality, or the varia- 
bility of the rheumatic pains. 

In regard to inflammation, opinions are just as much di- 
vided. All that we know of the Asiatic cholera is the manner 
in which it shows itself to our senses: the most penetrating 
observers have not yet succeeded in observing its seat. Hun- 
dreds of bodies have been dissected; the blood of cholera pa- 
tients has been analyzed; the crudest empiricism has been re- 
sorted to in administering piecemeal the most heterogeneous 
medicines, and yet, according to the testimony of the public 
authorities, no more patients have been saved in this way than 
the homoeopathic physicians have saved with their simple 
method. It might be said in reply to this, that the cholera was 
too recent a disease to admit of any profound inquiry into its 
inmost nature; but our knowledge of a great number of other 
diseases, which occur very frequently, is unfortunately not 
much more accurate. For years past so much has been said, 
for instance, about delirium tremens, that one should think a 
satisfactory explanation of the nature of that malady might 
have been arrived at by this time; but, in perusing the differ- 
ent works which have been published on that subject, we en- 
counter the most contradictory hypotheses by the side of thera- 
peutic principles which do not agree any belter with the theory. 


It is not yet ascertained whether in delirium tremens the hrairt 
is affected primarily or by sympathy. Armstrong considers 
delirium tremens a venous congestion of the brain and liver 
consequent upon an increased action of the heart and arteries 
occasioned by a previous irritation. Klapp derives the cerebral 
affection from a disturbance of the digestive organs ; Sandwitk 
from a venous congestion of the abdomen ; Haugthon from an 
inflammation of the stomach ; Playfair from a morbid condition 
of the liver and the intestinal secretions. According to Goeden, 
the seats of the disease are the solar and cceliac plexuses, and 
the cerebral affection is merely consensual. Gunther thinks 
that the cerebral affection is partly idiopathic, occasioned by 
metastatic deposits, partly consensual, occasioned by the gas- 
tric irritation. Toe p ken supposes that the cerebral affection is 
consensual, and emanates from the coeliac plexus. According 
to Perry, the affection consists in a febrile cerebral affection, 
which is to a considerable extent of an inflammatory character. 
According to Sutton, it is a particular irritation of the brain 
bordering on frenzy. According to Andrece, it is a real inflam- 
mation. According to Bischoff it is an asthenic cerebral in- 
flammation. Harless considers delirium tremens a superficial 
cerebral inflammation, rather of an erysipelatous nature, an 
asthenic paraphlogosis of the meningeal membranes and of the 
brain. Blake thinks that it is an indirect weakness of the 
nervous force, occasioned by a morbid activity of the brain and 
nerves. Huf eland supposes that it is nothing but a passive 
nervous delirium. Wasserfuhr admits that the alcohol is 
transformed into blood, whence comes intoxication, until a con- 
tinuous cerebral affection ensues, when the organism is no 
longer able to assimilate the alcohol. According to Spaeth, 
the cerebral affection results from a rupture of the equilibrium 
existing between the brain and the abdominal nervous system. 
William Stokes recognizes two principal kinds of delirium 
tremens, one arising from the want of irritability, for which he 
prescribes a severe diet ; the other from an excessive irritation, 
which he combats by means of leeches and ice. 

We might go on multiplying these quotations to show the 
difference between the opinions j but it suffices to take the first 
best monograph of any disease, to become convinced that, 
although we possess a large number of excellent descriptions 
of disease, yet all our knowledge relative to the causes of disease, 
is scarcely any thing but speculative, and a tissue of contradic- 
tions. The opponents of the specific method of treating dis- 
ease generally overlook the frank confessions of such men as 
Boerhaave, Peter Frank, Huf eland, Hildenbrand, and of so 



many other estimable savans, in regard to the imperfections of 
medicine ; and they do not hesitate to designate by the term 
rational any treatment, even unsuccessful, which is based 
upon a hypothesis, provided it is defended with a show of logic. 
That kind of logic, however, is of less importance to the pa- 
tient than his recovery ; the patient cares little about the princi- 
ples of the school, an ideal system : he wants to be cured.* 

The physician who obstinately pursues an ideal object, 
frequently loses sight of the actual object of his treatment. 
Mesmer was once asked what baths were most healthy; he 
answered : Formerly it made no difference whether a bath was 
taken in a room or in the open air ; but ever since I have mag- 
netized the sun it is better to bathe in water that the sun is 
shining upon. Another learned man, who is still living if I 
am not mistaken, and who has made himself known by his 
medical publications, magnetized, some years previous, the 
university buildings of Heidelberg, in order to inspire the stu- 
dents with a higher enthusiasm for science. Such errors excite 
our mirth, whereas the daily example of the obstinacy with 
which prejudices are defended, excites rather our compassion. 

The celebrated author of the work on " Experience" the 
Chevalier Zimmermann, saw in every disease visceral ob- 
structions, and prescribed to all his patients dandelion, on which 
account he was surnamed the Knight of the Dandelion. I 
know a well-informed physician who imagines that in every 
case of disease that he treats there is some latent affection of 
the spleen. Some see in every disease masked gout ; others 
lose themselves in the dark region of the piles ; others again, 

* Some time ago I lent to a learned friend of mine, who is no profes- 
sional physician, a manual of special therapeutics which is in the hands 
of every physician. He wished to consult the work in relation to the 
case of a person who was closely allied to him. On returning it to me, 
he told me : " The reading of this book has discouraged me entirely, for 
I had a much higher idea of your science ; but all I found, was a variety 
of methods according to which this or that disease can be treated, with- 
out discovering any specific indications for one or the other method. 
It seems to me, therefore, that it is the caprice of the physician which 
decides about the method, and that the patient's life frequently depends 
upon the chance of a lucky choice ; if the cure does not take place, 
physicians have always some authoriy to shield themselves by." — I re- 
plied that a manual of therapeutics could not be as positive as that of a 
brewer or dyer, and that it must be left to the judgment of the physi- 
cian to decide what method is the best in every case. My friend, 
however, was perfectly right in saying, that too much room is left to 
the arbitrary disposition of ihe physician, and the patient's fate fre- 
quently depends upon the school in which he has formed himself, upon 
the system he lias adopted, or upon the method he follows. 


with Hahnemann at their head, suspect nothing but latent 
psora ; others, lastly, trace every disease to some rheumatic 
affection, and, whatever the patient may say, they will succeed 
in making out that the functions of the skin had been disturbed 
some time previous. Upon this supposition they wrap him in 
flannel, ana administer sudorifics, which make him still more 
sensitive to the disturbing action of the air. At the present 
time, tubercles in the brain, ulcers in the intestines, inflam- 
mations of the spinal marrow, are all the fashion, and serve to 
account for a great number of morbid conditions. No system 
.has as yet succeeded in limiting this arbitrary mode of gener- 
alizing, and this mania of tracing certain fundamental dis- 
orders. Frequently, however, the wish has been expressed of 
possessing a therapeutic law which would give us some cer- 
tainty, and would enable us to avoid the danger of groping in 
darkness, or losing ourselves in the maze of hypoiheses. 

For many years, in order to apply a rational treatment, and 
conform to the principle, tolle causam, physicians have en- 
deavored to determine by their reason the proximate hidden 
cause of disease, and to base their treatment upon such a 
cause. This treatment has been more or less successful, ac- 
cording as one started from premises that were more or less 
correct. The tendency to idealize, to arrive at a knowledge of 
the invisible causes of disease by pure reason, is the dangerous 
cliff that Samuel Hahnemann has endeavored to avoid in esta- 
blishing the principle that nothing can be known of disease 
with certainty except its perceptible phenomena. With this 
principle he has coupled the assertion that this is all that a phy- 
sician who is otherwise acquainted with the pathogenetic 
effects of drugs, requires to select the proper remedy. The 
author of this doctrine has developed it with a boldness which 
has scarcely ever been equalled ; and, in order to make the 
want of fixed principles more keenly felt, he has described the 
weak sides of the old school in the most repulsive colors, deny- 
ing that it has been of any use whatever. The partisans of 
the old school, called rational not without a good deal of pre- 
sumption, have used every endeavor to preserve for it the in- 
fluence it enjoyed, and to cover the new doctrine with igno- 
miny. The revolutionary boldness with which it overthrew 
every thing which had been previously admitted in medicine, 
excited an extraordinary sensation. It would be improper to 
find fault with the desire implanted in human nature, to pre- 
serve what had been carefully cultivated for years. Frequent- 
ly, however, that desire increases to a censurable conservatism, 
betraying weakness, an unwillingness to free one's self from 


the yoke of habit, or a condemnable egotism which is averse 
to follow the road pointed out by some one else. Equally cen- 
surable are the vehemence with which young and inexperienced 
disciples of Hahnemann have ridiculed every thing which had 
been clone in science without being able to appreciate it, and 
the presumption with which, after one or two lucky cures, they 
have considered themselves capable of curing any case of dis- 
ease. But the doctrine itself ought not to be confounded with 
the weaknesses of its partisans. The extravagant praise which 
is bestowed upon it by some ardent admirers, ought to be re- 
ceived with caution, although the unjust and malignant criti- 
cism of its vehement opponents is justly condemnable. 

The new doctrine, such as it has been presented by Hah- 
nemann, and admitted as sacred by a great number of his 
disciples, does not, in our opinion, satisfy a just and impartial 
criticism. But the homoeopathic principle, which is the corner 
stone of the new doctrine, is so important, and after careful ex- 
periments, has been recognized by so many physicians free 
from prejudice, that the overthrow of the homoeopathic school 
need no longer be apprehended, notwithstanding the hazardous 
or uncertain assertions with which the doctrines of that school 
are interwoven. We make this statement in the supposition that 
no higher principle of cure will be discovered hereafter. 
Among the adherents of the homoeopathic school, there are 
some who do not adopt all the opinions of Hahnemann, and 
who do not follow his precepts without examining them criti- 
cally. I beg leave to remind my readers of the remarks, 
which I have offered in 1824, in the first edition of my work, 
entitled, on the value of the homoeopathic treatment, and which 
were intended to show the necessity of cultivating the new 
doctrine scientifically. Others have felt that necessity, like 
myself; have proclaimed it without fearing the reproaches of 
those who delight in servile obedience and have made every 
exertion to discover errors, reject inadmissible hypotheses, sub- 
mit dubious assertions to a severe criticism, and, above all 
things, develope the new doctrine. 

Attempts have been made, to combine homoeopathy and 
the old system of medicine. But all such attempts must prove 
fruitless, for the simple reason, that the therapeutic principles 
of the old school are contrary to those of the new, although 
the general object of the treatment, the restoration of health, is 
the same in any system of medicine. 

The science of therapeutics includes three different princi- 
ples, and as many different methods. They are : 

1. The antipathic or enanthiopathic method, based upon 


the ancient principle of Galenus : Contraria contrariis oppo- 
nenda.' According to Galenus, the rational treatment of disease 
consists in always administering remedies which, by their 
primary action upon the organism, produce a condition opposite 
to that which it is intended to remove. The antipathic treat- 
ment must necessarily have been the first that suggested itself to 
the mind. He who has burnt his hand, is impelled by some 
internal movement to plunge it into cold water; he who sutlers 
with cold, endeavors to get in a warm place; he whose tongue 
is dry and parched, endeavors to moisten it by drinking cold 
water. Cathartics are opposed to a constipation of the bowels, 
astringents to diarrhoea. When the system is heated, and the cir- 
culation is tumultuously agitated, refreshing things, nitre, crea- 
mor tartari, lemonade, are administered ; if the coldness one expe- 
riences is supposed to be owing to a sluggish circulation, heat- 
ing things are resorted to, to accelerate the circulation of the 
blood ; in relaxation of the system, tonics, astringents, &c. are 
resorted to. 

The chemical school teaches the same principle in its 
fashion, and of course, in accordance with hypothetical as- 
sumptions only, applies remedies to restore the natural propor- 
tion of the component molecules. Thus alkalies are given 
to correct a supposed hyperoxydation, acids to supply a sup- 
posed deficiency of oxygen, &c. 

The idea of antipathic treatment should not be rejected 
generally, as has been done by some vehement advocates of 
the specific method ; peaceful, impartial and experienced ob- 
servers will keep aloof from that blind zeal, and will not deny 
the happy results which have been obtained by the antipathic 
method. To appreciate this method properly, it is necessary to 
look at practice, and particularly at the therapeutic indications 
in accordance with the principles of the antipathic school. 
These indications, provided we do not resort to a purely symp- 
tomatic treatment, should correspond to the idea which we 
have conceived of the discord existing between the elements of 
vitality. The symptoms are mere means to obtain a correct 
idea of the nature of that discord. It is upon this idea that the 
treatment is based. Isolated symptoms do not require any par- 
ticular attention. Like unto rays emanating from a central 
fire, they will disappear as soon as their focus is extinguished. 
This result is obtained in every case where the diagnosis is 
surely established, and some apparent contradiction between the 
symptoms does not induce one to abandon the original plan of 
treatment. The true physician, for instance, after having re- 
cognized a real plethora, will not be induced by the patient's 


complaints about lassitude, heaviness of the limbs, to adminis- 
ter corroborants— or, in a case of carditis, he will not be induced 
by the tremulousness of the pulse, the decomposition of the 
features, the fainting spells, to combat this apparent.sinking of 
the vital forces by abandoning the antiphlogistic treatment. If 
we knew the principal disorder in every case, it would not be 
difficult for us to remove it wherever this is possible. Unfor- 
tunately, however, we cannot disguise the deficiency of our 
physiological and pathological knowledge. We hear it often 
said, for instance, that this or that man who has some inflam- 
matory disease, might be saved if he could be bled once more, 
which his weakness will not allow. In such cases, physicians 
consult, and after all they do not know how to get out of the 
dilemma. As long as pathologists will teach that the principal 
seat of an inflammation is in the blood, and not elsewhere, 
where oiher remedies might be applied, we shall hear com- 
plaints about the uncertainty of onr therapeutic indications. 

We frequently see persons suffer with weakness of the di- 
gestive organs, and at the same time with determination of 
blood to the head, with symptoms of congestion. These latter 
symptoms induce us to have recourse to cooling salts ; but we 
have to fear that salts will derange the stomach still more. 
The stomach might be fortified by bitters, if they did not heat 
the blood. Physicians frequently endeavor to get out of this 
difficulty by mixing the two kinds of remedies, one being ex- 
pected to fortify the stomach, and the other to diminish the vas- 
cular erethism, while the pernicious effects of the tonics are 
supposed to be at the same time neutralized ; as if this mixture 
did not constitute a new body acting altogether differently from 
what each constituent would do if administered singly. Would 
it not be wiser to endeavor to determine the fundamental cause 
which occasions the apparently contradictory phenomena of 
disease in the different parts of the organism, and to direct the 
treatment against that cause exclusively? The difficulty of 
solving that question in every case, and of following a single 
indication in the treatment of disease, leads us to select our re- 
medies in accordance with the symptoms manifesting them- 
selves in the various systems and organs of the organism, com- 
mencing with those symptoms which appear the most import- 
ant to us. This treatment is really a symptomatic treatment. 
However much we repel this accusation, it is nevertheless 
merited, as any one may see who will take the trouble to read 
the numerous so-called cures which are related in our journals. 

It is not difficult to understand that a disease might be cured 
antipathically, provided we knew its proximate cause. A 


treatment which is only directed against isolated symptoms, is 
always incomplete, and frequently pernicious, inasmuch as 
there is danger of repressing reactions, by means of which the 
organism, if left to itself, might have freed itself from disease. 
Moreover, the antipathic method cannot be applied in every 
case, because we do not know the contrarium of every anoma- 
lous condition of the organism, and have it only in our power 
to remove it empirically, but not in accordance with the prin- 
ciple : " Contraria contrariis Miranda." To this category be- 
long a number of affections, particularly disturbances of the 
sensitive sphere, and a majority of the dyscrasias, of the 
essential nature of which we are almost completely ignorant. 

The history of medicine mentions a great number of cele- 
brated practitioners of the old school, whose reputation no one 
would dare assail. But their reputation rests less on the strict 
observation of the rules of their system than upon their 
talent of observing, and upon the faculty which they possessed 
of determining in which cases the antipathic treatment 
would be salutary, and in which it would be hurtful, by pre- 
venting the curative reaction of the organism. The greatest 
skill frequently consists in recognizing the necessity of simply 
observing the reactive process ; whereas on the other hand the 
inopportune exhibition of excessive doses of heroic antipathic 
remedies betrays a lamentable want of pathological knowledge, 
an incapacity of comprehending the importance of the symp- 
toms. The inadequateness of the antipathic treatment, which 
has been acknowledged for a long time past, has led physi- 
cians to adopt some other method either in conjunction with it or 

2. The revulsive method, which probably owes its origin 
to the observation that certain forms of disease disappear, si- 
multaneously with the appearance of some other disease. 
This fact is accounted for by the sympathy existing between 
the different systems of the organism, or between the different 
organs of those systems. This sympathy is one of the essen- 
tial conditions of the antagonistic treatment. It is useless to 
inquire whether nature possesses a genuine, spontaneous cura- 
tive power, transferring the disease from noble and important 
to less important parts, or whether these transpositions take 
place in accordance with the laws of vitality without any par- 
ticular object of cure. It is well known that the morbid pro- 
cess is just as frequently transferred from inferior to more 
important parts, and that light and severe affections succeed 
each other by turns. An inflammatory irritation of the mem- 
branes of the brain may go off by a fluent coryza, a diarrhoea, or 


some rheumatic eruption, or by some other favorable crisis, as 
such operations are called. On the other hand, irritation of ihe 
cerebral membranes may be occasioned by the suppression of 
those affections. Vertigo, hemicrania, even apoplexy, may be 
cured by the appearance of piles, or may be occasioned by the 
suppression of the latter affection. The doctrine of the curative 
power of nature might therefore be very properly looked upon 
as a chimera, if it had not other points of support than the above 
mentioned observation, from which we might just as well infer a 
tendency inherent in the individual life to destroy itself. Be this 
as it may, the fact that diseases wander from one organ to an- 
other, has given rise to the revulsive method, which consists in 
removing an affection from the more important organs, by ex- 
citing an artificial affection in an organ of less importance, 
which it is supposed will neutralize the former by the laws of 
sympathy and antagonism. Any one who has observed the 
facts with care, will admit that this method is not as contempti- 
ble as some superficial physicians imagine, and the vehemence 
with which every thing which does not directly contribute to 
the glory of the specific treatment has been rejected by some of 
its blind admirers, can only excite regret. It may be often 
justly said, that every thing is gained by gaining time. It is 
particularly in acute affections of some vital organ, where the 
danger is imminent, that every thing is gained by transferring 
the disease to some inferior and less important part. Thousands 
of individuals have been saved by frictions, cupping, sinapisms, 
vesicatories, artificial ulcers, irritating friction on the skin, foot- 
baths, clysters, etc. The revulsive method has not been limit- 
ed to these external revulsions ; even internal organs have been 
irritated, and have been made sick by artificial means, in 
order to free a more noble part of the organism from disease. 
The efforts of the revulsive method have been particularly di- 
rected to the intestinal canal, the kidneys, skin. In conse- 
quence, cathartics, diuretics, sudorifics, have been prescribed. 
Attempts have even been made to transfer the affections of one 
system to some remote part of the organism, congestions of the 
brain or lungs, for instance, to the hemorrhoidal system. When 
life was in danger, and it became necessary to choose the lesser 
evil between two, in inflammation of the brain, for example, 
calomel has been unhesitatingly resorted to, to remove the in- 
flammation by exciting a temporary state of suffering in the 
intestinal canal. In order to unite the antipathic and revulsive 
methods, medicines have frequently been administered which 
corresponded to either object. In cerebral inflammations, for 
example, calomel has been administered especially, since it 


acts antipathically on the vascular irritation, increases the 
serous secretions of the intestinal canal, and thus manifests, at 
the same time, antagonistic effects. It would not be just to re- 
ject the revulsive method entirely. Of course it cannot be de- 
nied that it has frequently been carried too far. 

Not knowing the remedies which act directly against any 
morbid condition of the organism, a simple revulsion has fre- 
quently been deemed sufficient, particularly when some dys- 
crasia was supposed to be the cause of the affection. The in- 
testinal canal is frequently ruined for life by the abuse of dras- 
tic medicines. Setons and vesicatories are left on a patient for 
years, and these means, as well as cauterization and moxas are 
considered so lightly, that hospitals have become real places of 
Torture. The pernicious effects of the abuse of revulsive means, 
particularly of those which are employed internally, cannot be 
denied. Those which are employed externally, are likewise 
very hurtful frequently. Frictions with tartar-emetic ointment 
frequently occasion spreading ulcers, and leave horrible scars 
behind. Issues weaken the limb where they are applied, oc- 
casion atrophy of that limb, not to mention the bad smell which 
is occasioned by a constant suppuration. Vesicatories frequent- 
ly occasion dysuria, and cauterization is one of the most dread- 
ful operations, merely on account of the pain which is inflicted 
on the patient. Is it not desirable that these tortures should be 
abandoned, and that milder means of healing should be sub- 
stituted? We have a right to expect that result ever since the 
discovery of 

3d. The specific method. Specific remedies have been pre- 
scribed for a long time previous; but a specific curative me- 
thod, properly speaking, was not known. Unacquainted with 
the action of remedial agents, they had to be administered in a 
purely empirical manner, and the idea of a rational treatment 
was abandoned in despair. This latter treatment was gene- 
rally resorted to only when any other seemed inadequate to the 
case. Hence it is, that in the therapeutic manuals, any reme- 
dial agent which seems to be suitable to the disease, is men- 
tioned prior to the so-called specific remedies, of which nothing 
was known except that they had sometimes proved useful 
when any other remedy failed. It is a matter of surprise that 
the sometimes inordinate desire to explain and investigate 
things, should not yet have induced physicians to inquire into 
the laws which govern the action of specific remedies, inas- 
much as nothing in nature takes place contrary to laws. 
Theophraste talks a good deal about specifics, but he desig- 
nates them by the term arcana, and according to his fanciful 




notions, the effects of those arcana depend, in a great measure, 
on the influence of the stars. In some other passage he rejects 
entirely the maxim of contraria contrariis curantur, and says 
that diseases are cured by remedies affecting the organism simi- 
larly to the disease. Erastus accounts for the virtues of spe- 
cific remedies by their form and temperature, which is no ex- 
planation at all. Cardanus likewise doubts the old maxim of 
contraria, since a diarrhoea is frequently cured by purgatives. 
But the idea of homoeopathic treatment has evidently not been 
clearly alluded to by any of the above mentioned authors, ex- 
cept by Basilius Valentinus, who says that like cures like, 
but that contraria do not cure. Several later writers, especially 
Boidduc, Detharding; Thoury, de Haen, have explained the 
action of specific remedies upon the ground of similarity. 
Stoerk has gone farther in this view than any other writer be- 
fore him ; he suggests, with a certain timidity, that stramonium 
might cure derangement of the mind, for the reason that it de- 
ranges the reason of healthy persons, interrupts the train of 
ideas, modifies the perceptive and functional power of the 
senses. The suggestions of this writer, and similar observa- 
tions, have, however, not been improved; and the road which 
was here pointed out to inquirers, has never been travelled. 
The reproach of neglect in a matter of so much importance, 
concerns all those who had exerted themselves for a long time 
to advance medical science. It is frequently the case, that, by 
studying in a certain direction, we overlook the things in our 
immediate neighborhood. As regards the value of the disco- 
very itself, it matters not whether Hahnemannhas been led to 
it by the remark of some author whom he was reading, or by 
his own observations and reflections. He has the merit of 
having proclaimed the important fact that any remedial agent 
may be a specific, and that any disease can be specifically 
cured by a remedy which is capable of producing a similar 
disease on healthy persons. We will not examine whether 
Hahnemann has called his doctrine Homoeopathy for the pur- 
pose of distinguishing it ; we may slate it, however, as our 
opinion, that the appellation of specific doctrine of healing, 
would have secured a larger number of converts, and that he 
has been wrong in designating the old school systems of medi- 
cine by the collective name of allopathy. The revulsive me- 
thod is frequently similar to the homoeopathic, inasmuch as its 
object is in many cases to excite similar affections, though in 
different parts of the organism. 

The principle " similia similibus " is the barrier which se- 
parates the New from the Old School. It is impossible to com- 


bine these two schools; any such combination would consti- 
tute a most miserable abortion. Whether, however, the study 
of the old school system of medicine is made useless by the 
homoeopathic doctrine, is a different question. 

However strange this question may appear, it has been pro- 
posed a number of times latterly, and answered in different 
ways. Hahnemann has hurled the empirical principle which 
he had discovered, like a ray of lightning in the midst of me- 
dical'science, which he was on the point of annihilating. After 
passing a bitter censure on every thing which had been done 
in medicine so far, he hurls every doctrine of the pure reason 
in the dust, shows the deficiency of physiology and pathology, 
declares that the physiological and pathological doctrines are a 
tissue of falsehoods, and accords to the perceptions of the senses 
an absolute pre-eminence over speculative theories, and over 
any attempt to obtain by pure reason an image of the dynamic 
relations of the internal organism which are hidden from the 
senses. All that he requires is a careful study of the external 
phenomena of disease, which, in his opinion, are all-sufficient to 
enable the physician to select the proper specific remedy. It is 
needless to say that a method which only embraces the exter- 
nal phenomena, cannot be any thing else than symptomatic. 
It is certainly excusable on the part of Hahnemann, that he 
should have been dazzled by the splendor of his own discovery, 
and that he should have even contradicted himself by indulg- 
ing speculation in establishing his psora-theory. But it is a 
matter of regret that less experienced and less learned men 
should, in imitation of their master, have endeavored to over- 
throw every thing which had been built for the last two thou- 
sand years. The result of all these endeavors has been, that 
the school of Hahnemann has been reproached with arresting 
the progress of science by a leaning to empiricism. Eccentric 
partisans of the homoeopathic doctrine have been led by their 
sanguine hopes to deceive themselves and others ; and, to hear 
their promises, one might feel tempted to believe that the pana- 
cea of Paracelsus had been found, and that henceforth no one 
would die except of old age or some violent mechanical disturb- 
ance of the organism. These illusions have been favored by 
the publication of some wonderful cures, and by the sale of 
portable medicine-chests and domestic physicians, tending to 
represent the practice of medicine as very easy, and to make 
every man his own physician. Even laymen began to treat 
disease, and to write in favor of the new doctrine. This it was 
which furnished the opponents of homoeopathy with the means 
of bitter satire against the new doctrine ; and it is precisely the 


extravagant zeal and the exaggerated promises of some of its 
partisans which prevented many from studying it. Calm ob- 
servers, however, have remained true to the ancient rule, of 
abusits non tollit usurn, and have for a long time been endea- 
voring to free the healthy germ of the new doctrine from the 
weeds which threatened to choke it. In this way the materials 
of a new system have been accumulated, which I shall endea- 
vor to build up : I shall indulge, however, a few other remarks, 
which I deem necessary to enable my readers to judge this 
Essay with kindness and equity. 

It is impossible to build up, by mere reason, a complete 
system of medicine based upon the theory of life. Every at- 
tempt of this kind has so far failed ; and, in the present state 
of science, I should not be more fortunate than my predeces- 
sors have been. We ought to endeavor, however, and we are 
able to show, that the fundamental principle of our doctrine is 
in accordance with the general laws of life. 

Any combination of precepts arranged into one unit, agree- 
ably to one and the same principle, is a system ; and such a 
system, if it correspond to the actual state of development of 
the mind, will satisfy, momentarily at least, every reasonable 
exigency, provided the following conditions are fulfilled by the 

1. The principle which unites the different parts of a 
doctrine must be true, no matter whether the doctrine is de- 
rived from repeated experiments, or from speculative reason. 
If we consider the tvQtjxa of Archimedes, and the fall of an 
apple which revealed to Newton the law of gravitation — if we 
examine the forces of nature generally, we will soon become 
convinced that it is not by speculative reasoning, but by obser- 
vation, that we obtain an insight into the laws which govern 
the phenomena of nature. Truth, whether historical or empi- 
rical, must be conformable to laws. If, after repeated observa- 
tions, some phenomena should remain unexplained, this should 
induce us modestly to admit that we are not yet able to ex- 
plain every thing, and to continue our investigation of first 

2. The different parts of the system must likewise be 
true. It has already been stated that it is impossible to con- 
struct a system of medicine based upon one fundamental prin- 
ciple and consisting of an uninterrupted series of inferences. 
But in order that the different parts of Science may present 
an harmonious whole, they must be connected with one 
another by one and the same general principle. This scientific 
unity is not necessarily endangered by our inability to demon- 



strate it at once to our complete satisfaction, or by the existence 
of some apparent incoherence among the details. Of course a 
system commends itself the more to our reason, the greater 
the correctness of its precepts. Hahnemann thought he would 
make his system much more solid by rejecting every admixture 
of philosophy, and by admitting only truths perceptible to our 
senses. This is the reason why the materials which he has 
made use of for his system, have only been drawn from two fields 
of science, nosography, and pharmaco-dynamics. In the 
same sense as nosography is a science of the senses, and only 
records the external phenomena of disease, without tracing 
their internal connection, so is Hahnemann's Materia Medica 
nothing but a record of the symptoms, by which our senses 
perceive the action of drugs upon the healthy organism. The 
homoeopathic therapeia is based upon this fundamental princi- 
ple : Administer in every case of disease a remedy which 
will affect the healthy organism similarly to the disease. A 
system of treatment which regards only the perceptible phe- 
nomena of a disease, must necessarily be a stumbling-block 
to the partisans of the dogmatic schools, who cannot be ex- 
pected to forsake the notion that the principal object of any 
treatment should be to remove the cause of the disease. And 
yet, if the symptomatic treatment should become perfect and 
leave nothing to desire, the so-called causal treatment would 
necessarily have to be abandoned. A number of objections have 
been raised against this treatment, some of which are important, 
others without foundation. It has been urged, for instance, that 
the homoeopathic treatment removes the symptoms without re- 
moving the cause. This reproach, if it can be made against 
any treatment, can only bear upon the possibility that, in cer- 
tain cases, the original form of a disease may be converted into a 
different one, without uprooting the disease. But this remark 
bears against the revulsive and even the antipathic method 
rather than the homoeopathic, for those methods teach express- 
ly not to combat isolated symptoms, but the totality of the symp- 
toms. It is also true that the physician has done every thing 
in his power when he succeeds in removing the perceptible 
phenomena of disease ; for these latter, being a reflex of a 
certain internal anomalous condition of the organism, which 
is generally designated by the appellation of proximate cause 
of the disease, the internal cause must necessarily cease to ex- 
ist when its external manifestations are removed. The fre- 
quent and often astonishing success of strict homoeopathic 
treatment, shows, moreover, that there is an intimate connection 
between the essence and form of a disease. It may therefore 


be asserted that the symptomatic treatment is generally more 
successful than the most energetic treatment which is simply 
directed against the removal of the supposed proximate cause, 
which remains so often hidden from our knowledge until it is 
revealed to us by some accidental circumstance. 

By following Hahnemann's precepts, failures like these are 
indeed avoided ; nevertheless it cannot be denied that the speci- 
fic method, if employed exclusively, is imperfect. This imperfec- 
tion is, in a great measure, occasioned by the imperfect devel- 
opment of the science of pharmaco-dynamics ; for we know 
that our inability to cure, as yet, a number of affections, arises 
principally from the fact that we are not yet acquainted with 
their specific remedies, and the perceptible symptoms are in 
a great many cases too obscure to enable us to select the specific 
remedy with certainty. It often happens that the essential 
symptoms are so much obscured by the consensual phenome- 
na, that the former are entirely overlooked, unless the physcian's 
skill and experience should discover them, and make use of 
•them as curative indications. 

It is therefore evident that medicine cannot be studied like 
trade; and that it is on the other hand impossible to carry it 
to such a height of perfection that mistakes become impossible ; 
the imperfections of the different systems and methods are still 
too numerous; the impossibility of arriving under the antipa- 
thic method at a certain knowledge of the proximate cause, 
occurs still too frequently ; the specific method furnishes yet 
too often an imperfect image of the disease; and lastly, any ex- 
isting system of Materia Medica is yet xery incomplete. There 
have been errors in medicine ever since disease has been treated, 
and there will be errors to the end of the world. The unintelli- 
gent physcian, no matter of what school, will always run the 
risk of deceiving himself; and the well informed physician, who 
knows every system, but does not allow himself to be blinded 
by the love of system, will be more fortunate than others, in 
the treatment of disease. In every school the physician has 
to possess the necessary preliminary knowledge, of separating 
the ideal portion of our doctrine from that Avhich has been re- 
cognized as true and practical, of acknowledging the defects of 
some branches of medicine, rather than to supply them by unpro- 
fitable hypotheses; and, above all, of not allowing himself to 
be led by the apparent importance of certain speculative notions 
to maintain obstinately ideal representations of the proximate 
cause, and to expose the patient's life by directing an heroic 
treatment against supposed occult qualities, instead of against 
the disease. Boerhaave esteems the physician fortunate who 


does not do any positive injury. In this respect the homoeo- 
pathic physician would be better off than any other. But in 
following literally Hahnemann's precepts, the physician might 
become guilty of the crime of omission, and one might justly 
condemn his treatment partially as inefficacious, since he ne- 
glected the accessory means, which, beside the symptoms, may 
lead to a correct knowledge of the disease. We need not 
quote cases to show that the strictly Hahnemannian treatment 
of disease has frequently been uncertain. Conscientious adhe- 
rents of Hahnemann have felt that uncertainty for a long time 
previous ; they have become convinced that the mere external 
symptoms are not the only curative indications, but that they 
constitute the reflex of some internal dynamic disorder which 
can only be recognized by the mind's eye, and requires to be 
known,. in order to base the treatment upon as safe a basis as 
possible. It is only in this respect that a union of the Old and 
New School can be thought of. The latter, proclaiming the 
principle, " similia similibus," will always maintain a distinct 
rank, and will never be confounded with the antipathic treat- . 
ment, but will cease to be Hahnemannian. The author of 
this doctrine, who undoubtedly possesses the glory of having 
laid the corner-stone, could not be expected to complete his 
work. It is for us to perfect it ; and we shall succeed in so 
doing by picking out the particles of truth in whatever system 
we may find them, and arranging them, by means of the spe- 
cific principle, into one harmonious whole. As we obtain a 
deeper and more correct insight into the modus operandi of a 
specific remedy, the homoeopathic law, which has been dis- 
covered empirically, will be more deeply founded in, and will 
finally become identified with, reason. 




Section 1. 

Self-preservation is the first and most remarkable manifes- 
tation of individual life. 

The tendency to self-preservation is common to the spe- 
cies, as well as the individual. This tendency is so much in- 
herent in the vegetable and animal life, that we may, with 
Leibnitz, consider the tendency to preserve one individuality, 
as the principal object of life. One of the most astonishing 
phenomena of the organization of the great whole is, that 
every organized being produces only its like. This arrange- 
ment is doubtless necessary to preserve the harmony of nature, 
but the cause thereof is hidden in the mysterious bosom of life. 
All that we know on this subject has been derived from observing 
the species and the individuals which perpetuate themselves ; 
it is thus that we have arrived at the idea of a vital princi- 
ple incorporated in the germ, and which we recognize as the 
internal cause of the organic formation and development of de- 
terminate genera and species. 

Section 2. 

The tendency of the individual life to preserve its individu- 
ality manifests itself by opposing the surrounding influ- 
ences of Nature. 

An acting force can only be thought of as existing in con- 
flict with a contrary force. Even Aristotle has said that op- 


position is the cause of all things. We become convinced of 
this truth so much more as we observe the circumstances in 
which forces generally act. Elasticity, for instance, can only 
manifest itself when the elastic body is acted upon by some 
external force endeavoring to alter the form of the body, and 
resisted by the latter. The extraordinary effects of steam are 
realized by opposing or limiting the expansive power of that 

The vital principle in individuals manifests itself by op- 
posing the surrounding influences of Nature, particularly by 
absorbing, transforming, and assimilating certain external sub- 
stances to maintain its own existence. 

Section 3. 

The mode in which the individual life opposes the surround- 
ing influences of Nature, depends upon the more or less 
perfect organization of the individual. J 

By " receptivity " we understand the property inherent in 
animated individuals of being modified by external influences ; 
not a condition of passive submission, as that of the wheel 
which is set in motion by the fall of the water, or of the clay 
which yields to the pressure of a heavy body, and assumes a 
different shape under its influence. Animated bodies are in- 
deed influenced by surrounding nature, but are at the same 
time endowed with a power of resisting that influence. This 
power is generally called, u force of reaction, reactive force" 
and the resistance itself, " reaction." There are different de- 
grees of reaction even among the individuals of the same spe- 
cies, and likewise different kinds of reaction, inasmuch as the 
various genera and species of animated organisms differ very 
much from one another in their relations to the external world, 
and to the cosmic, atmospheric and telluric influences by which 
those organisms are modified proportionately to their degree of 
receptivity. Every individual life is in need of the external 
world, each in its own way, for its preservation. Rice cannot 
grow on the rock which is covered with the lichen parietinus ; 
and the lion would just as surely perish on the ice-plains of 
Siberia as the sable would in the deserts of Africa. What is 
nourishment to one species is poison to another, and has no 
sort of influence on a third. Wherever reaction takes place it 
is characterized by the nature of the individual. 

In the vegetable kingdom reaction is limited to the repro- 
ductive functions, to an opposition to the laws of affinity which 


govern the inorganic world, and to the assimilation of certain 
substances which are drawn from the external world. In that 
kingdom we perceive only slight indications of an activity re- 
minding us somewhat of the animal irritability ; for instance, the 
turning of the leaves of certain plants to the light, the closing 
of certain flowers after sunset; the movements of the dionea 
muscipula, of the hedysarum gyrans, of the mimosa pudica. etc. 
In the animal kingdom we perceive a vitality superior to 
vegetable life, and even controlling it ; a freer dynamic power 
of a superior degree, the material vehicle of which is the ner- 
vous system. 

Section 4. 

Health is the integral action of the vital functions, which 
has for its object the preservation of the individual. 

As the tendency to propagation is likewise inherent in the 
individual life, we might include the integrity of that faculty 
.in the idea of " health." Health, however, may exist long after 
the sexual functions have ceased ; it may even exist in indi- 
viduals who have been deprived from the commencement of 
the procreative faculty (although the loss of this faculty always 
indicates a restriction of the vital activity). The preservation 
of the individual is, however, not endangered by that loss. 
Eunuchs and castrated animals may enjoy perfect health to an 
advanced age. 

Section 5. 

The principal condition of health is a normal stale of the 


This requires : 

1. Regularity of structure; and 

2. Proper combination of the constituent particles. 

It is scarcely necessary to state that certain anomalies of 
structure, even if the vital force were otherwise perfect, may oc- 
casion irregularities in the functions, and unpleasant sensations, 
to such an extent that the individual cannot be looked upon 
as enjoying perfect health ; whereas on the other hand, certain 
defects of organization are so little hurtful to the preservation 
and propagation of the individual, and disturb so little the sen- 
sation of health, that we need not pay any regard to them in our 
examination of the pathogenetic causes. The greater or lesser 
importance of those defects depends upon the organs affected, 


and upon the intensity of the affection. Health would not 
necessarily be deranged, for instance, by the heart being locat- 
ed in the right side of the chest. One of the small cutaneous 
arteries may have become obliterated without disturbing health ; 
a similar defect existing in the aorta would endanger life. 

As regards the composition of the constituent parts of the 
animal organism, and the influence which they have on the vi- 
tal force, we must admit that all our inquiries have so far led to 
very unsatisfactory results, which is mainly owing to the fact 
that animated bodies cannot be subjected to chemical analysis. 
Death occasions results which we have no right to suppose 
existed during life. Let me advert, for instance, to the putre- 
faction of the uterus which is said to take place in malignant 
puerperal fevers, upon the ground that in post-mortem examina- 
tions that organ has been discovered in a putrid state. This 
disease has prevailed several times in the lying-in hospital of 
our city ; and the director Dr. Ritgen, has made the most 
minute researches on the subject of that disease, on account of 
its presenting a particular character of malignity. On examin- 
ing the uterus immediately after death by means of a speculum, 
no change is discovered. An hour after, a softening and a suspi- 
cious color are perceived, increasing every quarter of an hour 
until the uterus is found in a state of entire putrefaction, 
which some observers have looked upon as an essential cha- 
racteristic of the disease. The results of such observations, 
which have been frequently repeated with care, lead us to 
suppose merely a low sinking of the vital force, commencing in 
the uterus, which accounts for the fact that the chemical decom- 
position after death commences in that organ. Such and similar 
observations should make us cautious against admitting a num- 
ber of the results which pathological anatomy has furnished 
on the character of disease. Olliviers describes cases of sud- 
den death occasioned, as he "thinks, by the development of 
gas in the blood, where air-bubbles were discovered. It is diffi- 
cult to decide whether this gaseous development had com- 
menced before death. * 

Section 6. 

Disease is ananormal vital process which does not correspond 
to the true development of the individual. 

Laymen would be astonished to know that the difference of 

* That great changes take place in bodies after death, is shown by 
the virus with which dead bodies are infected. It is said that this virus 
is most active and poisonous shortly after death. — Hempel. 


opinion which prevails in regard to the forms of disease, like- 
wise exists in regard to the nature of disease itself. A critical 
examination of the different opinions which prevail on that 
subject, would transgress the limits of this work. In order to 
avoid unnecessary discussion, I shall not even attempt to reply- 
to the objections which might be made against my definition of 
disease. This definition is not opposed by the idea which has 
been adopted by some thinkers, that disease is a parasitical 
being or force which has invaded the individual, and is endea- 
voring to develope itself in the same. However poetical and 
ingenious this idea may be, yet it is of very little avail in the 
treatment of disease. 

It is indeed a remarkable fact that there are diseases offer- 
ing complete series of similar phenomena, which have in- 
duced us to speak of diseases instead of anormal conditions, as 
if diseases were something enjoying an independent existence. 
This notion has even prevailed among Paracelsus, Van Hel- 
mont, Sydenham, and several older physicians, and has led to 
a classification of diseases in genera, species, and varieties, and 
to the construction of nosological systems similar to the classi- 
fication of animals and plants in natural history. The ques- 
tion with us is: Why are many forms of disease so similar to 
each other? Not because there is a tendency in diseases to exist 
in the order in which they are described and collated in the 
books, or because, like unto a grain of seed in the soil, they 
take root in the living organism, develope themselves, and final- 
ly arrive at maturity in order to become extinct ; but because 
similar organisms are governed by analogous forces and laws. 
and will exhibit similar reactions when acted upon by similar 
causes. As long as the individual life has not become extinct 
either in the organism generally, or in a portion of the organ- 
ism, the changes which occur in the latter are subject to the 
control of its own laws. There is no such thing as a vital de- 
velopment of disease in accordance with regular laws. A ce- 
lebrated savant (Stark) has said : Disease is either a living con- 
dition and at the same time individual, or neither. This dilem- 
ma may be replied to by stating that condition means a totality 
of properties, and that disease is therefore not so much a living 
condition, as a certain condition of a living individual ; and 
that a condition, simply because it exists in time and space, 
need not therefore be considered a self-existing individual. 
This opinion meets its principal refutation in the fact that we 
cannot analyze or construct a form of disease without acknow- 
ledging the validity of physiological principles, and that we 
cannot account for the origin and development of disease, with- 


out accepting the laws of the organic life of the individual as a 
fundamental position to our inquiries and reasonings. This is 
admitted by the most zealous advocates of the doctrine that 
disease is a parasitical being, thus admitting tacitly that their 
doctrine is of no avail in practice. The transposition of a dis- 
ease by metaschematismus, is contrary to the notion that every 
disease is endowed with a tendency of developing itself agree- 
ably to its own inherent laws; or else it would be necessary 
to admit that every metaschematismus is the extinction of an 
old, and the commencement of a new parasitical life. This 
supposition leaves us entirely in the dark, if we attempt to un- 
derstand by its means, the mode in which the process of meta- 
schematismus takes place. Kieser has, therefore, very properly 
remarked, that it is a great mistake to consider a state of health 
and an anormal condition of the vital forces as opposite exist- 
ences. Whatever idea we may attach to the term " inflamma- 
tion," whether we consider it dynamically, or with respect to 
the perceptible changes in the inflamed part, the whole course 
of an inflammation shows that it is simply an alteration of the 
vital functions of a tissue or organ, without the supervention of 
new or strange laws, and that the various phenomena of inflam- 
mation are governed by the vital force of the general organism 
and the life inherent in its single parts. Swelling, heat, red- 
ness, pain, are consequences of what we consider the proximate 
cause of the disease, and the various terminations of an inflam- 
mation, dispersion, suppuration, induration, gangrene, or the 
formation of new filaments, membranes, etc., should be derived 
from an anormal reproductive activity of the organism, but by 
no means from an independent principle of disease by which it 
had been invaded. If the existence of such a principle were 
admitted, all attempts to elevate the character of pathology by 
establishing it upon a physiological basis, would become unne- 
cessary, and it would be impossible to account for the various 
modifications in the manifestations of the vital force, in a man- 
ner conformable to the known laws of nature. 

Section 7. 

Disease results from the cessation of the normal state of 
the vital activity. 

Disease is induced by 

1. Lesion of the vital force ; 

2. A normal condition, both in the form and composition of 
the organism. 


We distinguish therefore : 

1. Dynamic diseases ; 

2. Physical diseases, which may again be distinguished in 
anomalies of form and composition. 

We must not forget that matter and force cannot be con- 
ceived as two things essentially different, but that they are 
rather two things reciprocally related to each other in such a 
manner that one can only exist by and with the other ; indeed 
matter and force cannot be modified separately. On the other 
hand, we should not leave out of sight the great similarity ex- 
isting between the vital force and the imponderable fluids, 
whose dependence upon matter can only be shown very imper- 
fectly. What change takes place in the magnet at the moment 
when it loses its power in falling on a hard stone, or when its 
poles are reversed ? We know this as little as we do why the 
galvanized muscle ceases to react for some time, and, after a 
little rest, recovers the power of performing palpitating move- 
ments. A number of phenomena justify the admission of pri- 
mary lesions of the vital force ; for instance, instantaneous 
paralysis occasioned by a violent emotion, the frequent disap- 
pearance of serious symptoms by means of some moral influ- 
ence. King Perdiccas was cured of a consumptive illness by 
the sagacity of Hippocrates, who discovered that love was the 
cause of the disease, which disappeared as soon as that passion 
was satisfied. In a similar manner was the apparently dying 
Antiochus cured by Erasistratus. The inmates of the orphan 
asylum at Harlem ceased to be attacked with epileptic fits, 
which were brought on by the sight of a paroxysm, after Boer- 
haave had decreed that the first child that would be attacked 
with epilepsy, should be burnt with a hot iron. These and 
many other diseases are purely dynamic. 

The question here presents itself, whether there are distinct 
physical diseases. Defects of organization, anomalies of form, 
whether hereditary or of later origin, unless occasioned by me- 
chanical injuries, imply an irregularity in the reproductive 
functions, but may, from the moment they exist, be looked 
upon as organic diseases, provided they disturb the play of the 
vital forces. They are the objective phenomena of some dy- 
namic affection, although they may in their turn disturb the vi- 
tal force. Dilatations or contractions of the heart, for instance, 
aneurisms, obliterations of arteries occasioning disturbances of 
the circulation, are organic diseases. 

There is another still more important question, whether 
there are primary anomalies of composition, and particularly 
primary diseases of the fluids. 


If we put the question in this way : Are there diseases 
which manifest themselves in the first place by an anomalous 
composition of the fluids 1 we may unhesitatingly say : There 
are. Every organ and every sphere of the organism maybe 
first invaded by disease. Disease may commence in the sen- 
sitive sphere as well as in the reproductive sphere, and may oc- 
casion material changes in the latter, which is more particular- 
ly exposed to the influences of surrounding nature. But if the 
question be, whether external influences can produce a pri- 
mary corruption of the fluids by some chemical change, we 
may as unhesitatingly answer : No. 

The form and composition of the organism are the objec- 
tive manifestation of animal life in its reproductive sphere ; 
hence deviations from the perfect composition of the organism 
are the materialization of an anormal vital process, implying a 
disturbance of the vital force itself. This may be hereditary, 
for instance in scrophulosis, or acquired. In many cases it may 
be considered weakness ; that is, an insufficient quantity of power 
to resist the noxious influences which are constantly assailing 
the integrity of the organism. There are noxse which over- 
come even the most powerful organism, such as gases and poi- 
sons which pass into the organism by the lungs, or by the ali- 
mentary canal, or by the superficial absorbent vessels, occa- 
sioning death sooner or later. The resistance to those noxae is 
proportionate to the intensity of the vital force. Some men en- 
joy such a powerful vitality, that they are able to exist in the 
closest contact with noxious influences which would destroy 
the life of many others. The same man is more or less liable 
to noxious influences according as he happens to be in a 
stronger or weaker condition of body. Overwhelmed with 
care, exhausted by fatigue and watching, badly nourished, he 
is more liable to the influence of a contagious disease than if 
the contrary condition existed. He is likewise more liable to 
that influence when the stomach is empty, than after a good 
meal. Hurtful substances, even if introduced into the organ- 
ism, will prove less destructive if the organism is powerful and 
active, and therefore more capable of transforming the very es- 
sence of the noxious agent. 

Strictly speaking, all physical diseases may be traced to a 
violation, or, at any rate, to a relative weakness of the vital 
force ; and all diseases may, therefore, originally be considered 
dynamic. It is nevertheless convenient to inquire which of 
the three spheres is more particularly affected, the sensitive, 
irritable, or reproductive. Generally, the anomaly exists in one 
of these spheres ; in regard to the latter, it cannot be doubted 


that irregularities of composition frequently and primarily take 
place in the blood, owing to the introduction of heterogeneous, 
gaseous substances, such as contagia, miasmata, etc., by the 
respiratory organs. Nor can we deny that substances may be 
incorporated in the volume of blood, by means of the absorb- 
ents in the intestinal canal, where those substances may have 
been secreted or introduced. According to Loewenhayn, car- 
bonate of soda, which had been introduced into the stomach, 
has been discovered in the blood. Indigo tinges the milk of 
nursing females blue, and madder imparts a red color to the 
bones. These are facts which no one denies. The mode in 
which those changes take place, is explained in different ways. 
According to Von Pommer, miasmata, contagia, and poisons 
affect the blood primarily, alter and destroy the blood, and with 
it the being. Treviranus is of the same opinion, except that 
he thinks poisons act not so much by absorption as dynami- 
cally, inasmuch as the action takes place suddenly, like that 
of electricity. Boerhaave's well-known experiment with the 
opium pill, which was found entire in the stomach of the poi- 
soned dog, likewise shows that the organism may be affected 
by the mere contact with certain substances. Experiments 
like these, however, do not show that parts of the poisonous 
substance may not have been brought by absorption in more 
intimate contact with the organism ; and, after all, the differ- 
ence of opinion is in relation to the tissue which was affected 
primarily. Steinheim thinks that the re-action of the blood 
against poisons is a dynamic process. Lobstein, the most zea- 
lous advocate of nervous pathology, maintains that all organic 
diseases are in the first place dynamic, and that they all ori- 
ginate in a nervous disturbance, because no primary alterations 
take place in inferior systems, which must be conceded in so 
far as the morbid process, when it seems to be confined to the 
vegetative sphere, must necessarily depend upon a relative weak- 
ness of the higher animal vitality. 

Section 8. 

The different forms of disease are determined by the laws 
which control the manifestations of vitality. 

The notion that diseases are parasitical beings in the or- 
ganism, must have easily led to the supposition that the multi- 
tude of similar forms of disease depends upon the tendency, in- 
herent in those parasites to develope themselves in a peculiar 
manner, by virtue of the same power with which every living 


embryo is endowed, to grow up to an individual distinct in 
form and kind. Certain phenomena, indeed, tend to favor this hy- 
pothesis, particularly the contagious diseases, which run through 
their course, proceeding from the same seed, like animals and 
plants, and remaining the same in their fundamental features. 
A man infected by the small-pox, suffers for three, four, or five 
days, in pretty much the same manner with his companions of 
misfortune. After the lapse of that period he is attacked with 
a febrile paroxysm, followed by red spots. On these spots the 
epidermis is gradually raised, and blisters are formed, which 
fill with a purulent lymph in the space of eight days, du- 
ring which time the febrile paroxysms continue. In three 
days the blisters begin to dry up, and the disease generally 
runs through its course in from twelve days to a fortnight. 
The measles, rubeola?, the exanthematic typhus, and several 
other diseases run through such a similar course, in all those 
who are affected with such diseases, that it is quite easy to 
foretell, with a high degree of probability, from the first symp- 
toms of the infection, the whole succession of phenomena 
which will set in during the course of the disease. A certain 
regular course by stages, characterized by peculiar phenomena 
of the same duration, is not only characteristic of acute, conta- 
gious, exanthematic, but of many other, and particularly epi- 
demic diseases. If at a time when inflammations of the pul- 
monary pleura prevail, one should have been exposed to the 
predisposing influences of inflammation, and should then be 
attacked with a violent chill, succeeded by heat, stitches in the 
side, and oppression of breathing, we know by these symptoms 
that the disease has set in, and we are able to foretell that the 
cough and irritation will increase — that the cough will at first 
be attended with a blood-streaked expectoration, and afterwards 
with an expectoration having a reddish tinge throughout, that 
a crisis will set in on the seventh day, which, if favorable, will 
be accompanied with a warm sweat over the whole body, after 
which the disease will subside and gradually disappear. We pre- 
dict with tolerable certainty that a splinter which has penetrated 
into the flesh, unless extracted, will occasion an inflammation, 
and that the splinter will be expelled during the subsequent 
process of suppuration. All such predictions are based upon 
the' knowledge which we possess by observation, of the succes- 
sion of the effects which certain noxious influences produce in 
the organism. Frequently, however, the course of the disease 
is different from what we had observed previously. Splinters 
have remained in the flesh for years, without occasioning either 
inflammation or suppuration. Even acute cutaneous diseases, 


which are particularly distinguished by the similarity of their 
forms, frequently differ from one another. Small-pox has been 
seen resembling measles, and measles resembling small-pox. 
The stages of those diseases have been longer or shorter than 
usual. Such exceptions may depend upon certain peculiarities 
of the sick modifying the process of reaction. In every epide- 
mic disease the single cases differ somewhat from one another. 
In conclusion, it may now be asked : If disease is nothing but 
an alteration of the vital condition, and if the varieties of the 
forms of disease depend upon the relation existing between the 
receptivity and the reactive power of the patient, why should 
not this relation be considered the sole cause from which dis- 
eases derive their particular forms ? 

According to Ferdinand Jahn, the intervals of rest and the 
periods of activity of the earth and the organism are partially 
analogous to the type of diseases, or develope themselves as 
these do. Other diseases have an original type, which is pe- 
culiar to themselves. If we consider life as an original, self- 
existing power, and disease as a modified form of life, the cause 
of that modification must exist in the conditions of the indivi- 
dual life ; and there is no reason why every particular modifi- 
cation of the individual life should be supposed to be depending 
upon some particular life-principle. The life of the great 
whole is analogous to that of the individual, because all forms 
of life are controlled by certain supreme laws. A more or less 
distinct type is observable in every phenomenon of nature ; in 
the change of the seasons, in the tide of the sea, in the growth 
of plants and animals, particularly in the periods of develop- 
ment, in the waking and sleeping, in the processes of digestion 
and cohabitation, in the menstruation of females, in pregnancy, 
the hatching of eggs, and in diseases, where we frequently ob- 
serve a regular duration of the stages of intermission and exa- 
cerbation, particularly in fevers, where not only the vitality of 
single organs is disturbed, but where the reaction takes place 
throughout the whole organism, thereby showing the existence 
of general laws of life. In the man who is infected with the 
small-pox, the whole of the disease does not develope itself, by 
reason of its being endowed with a tendency to do so, but be- 
cause the living organism possesses the power of reacting in a pe- 
culiar manner : and if the phenomena of small-pox are the same 
in those who are infected with the disease, it is because the conta- 
gion of small-pox maintains the same character in all, and calls 
out similar reactions. We know but little of the nature of con- 
tagia ; but we may consider it certain that every contagium 
maintains a certain identity, and therefore calls out pretty 


much the same reactions in living organisms. Similar things 
take place in epidemic diseases which are not contagious. Our 
organisms are exposed to the influence of unknown agents in 
or above the atmosphere, which call out similar reactions in 
every invaded organism, differing from each other only in so 
far as the receptivity and reactive power of individual organisms 
differ. Hence it is, that in wide-spread epidemic diseases, not 
all men are seized with the same violence, though all those 
who are attacked, manifest similar symptoms of suffering. 
Noxae, which act with less intensity, cannot induce such con- 
stant and characteristic reactions of the organisms. These do 
not, in the first place, invade a particular organ or tissue, but 
the whole organism is attacked at once, and the morbid phe- 
nomena make their first appearance in that part of the organ- 
ism which is the most susceptible. This is the reason why a 
cold will induce catarrh, colic, diarrhoea, nettle-rash, glandular 
swellings, rheumatic pains, or other forms of disease, according 
as the organism is more or less disposed to either the one or 
the other. 

A celebrated author has remarked that diseases are apt to 
contract a certain type. Diseases are indeed apt to contract a 
certain type, but this fact is not explained by supposing that it 
is a sort of habit or something accidental. Hohnbaum suggests 
that the course of a disease is in a great measure regulated by 
the nature of the affected organ. The more necessary to life, 
the more tumultuous and rapid is the course of the disease, as 
we may see from the affections of the brain and spinal marrow. 
An inflammation of the heart frequently becomes fatal on the 
third day. Inflammations of the mucous membranes and of other 
inferior organs are more frequently disposed to become chronic. 
The diseases of those tissues and organs which, in their normal 
condition, perform their functions according to a certain type, 
follow a similar type in disease. Reactions of the vascular 
system particularly are distinguished by more or less regular 
exacerbations, because the action of that system is generally 
characterized by a certain rhythm. Piles appear in many per- 
sons every four weeks, and in many females fluor albus regu- 
larly precedes and succeeds the catamenia. All this shows 
that diseases are controlled by the same laws on which the 
periodicity and the rhythm of the functions in their normal con- 
dition depend. 


Section 9. 

Every disease is originally local. 

Long discussions have been carried on to know whether 
there are local diseases. Those discussions might have per- 
haps been dispensed with, if the meaning of the term " local 
diseases " had previously been well defined. What I under- 
stand by the term " local," is a morbid affection confined to one 
place, without occasioning a general disturbance of the organ- 

It has been stated, but incorrectly, that there cannot be 
any local diseases, because the vital principle is indivisible and 
cannot be invaded any where without suffering throughout its 
whole extent. To this we may reply, that it is indeed true 
that a severe local affection will be sympathetically perceived in 
every part of the organism, but that this sympathetic suffering 
is frequently so slight that it is scarcely, if any, perceived, and 
that it disappears as soon as the local disturbance shall have 
subsided. The pain which is caused by a carious tooth, 
ceases as soon as the tooth is extracted. The ulcer which is 
occasioned by a burn or vesicatory, is likewise a mere local 
affection, since it does not disturb the general functions of the 
organism. If the cure be prevented by some dyscrasia; if the 
ulcer assume a phagedenic aspect, the duration of the ulcer 
will depend upon the general morbid state which existed pre- 
vious to the ulcer, and requires to be cured in order that the 
ulcer may heal likewise. The healthier and robuster the indi- 
vidual, the greater its power of maintaining an affection within 
local bounds. 

There are also many local morbid phenomena which do 
not seem to affect the organism in the least, and which reflect 
a more general disease that had become latent in the organism 
ever since the vital force had succeeded in localizing it. A 
rheumatic fever disappears very often as soon as a slight erup- 
tion is seen on the lips, and the appearance of tinea capitis fre- 
quently frees children from a predisposition to inflammatory 
affections of the brain. The humoral pathologists consider 
this metaschematismus as a confirmation of their hypolhesis y 
that the matter which disturbs the organism has to be expelled 
in order that the equilibrium of the vital functions may be re- 
stored. We will not deny the excretion of certain hurtful sub- 
stances, whether they have got into the organism from without 
or have been produced in the organism by some anormal action 



of the vital forces. There are many such substances, such as 
the musty smell of the sweat in small pox ; the same pungent 
smell in miliaria ; the putrid smell in a cachectic disease ; the 
urinous smell in a state of inactivity of the kidneys. There 
have been observed alkaline sweats, sour sweats, or sweats 
that were sweet as honey, or mixed with crystals of phosphates 
or depositing a crust of sand on the skin. People with red 
hair have frequently an exhalation of a peculiar smell which 
disappears when they are indisposed, and the re-appearance of 
which is a sign of recovery. Frequently, however, alterations 
in the secretions take place, because the secretory organs are 
diseased, not because the organism is loaded with certain mat- 
ters the removal of which is required for the restoration of 
health. This statement is corroborated by the frequent con- 
centration and isolation of a disease in organs where no secre- 
tion takes place. The frequent disappearance of nervous dis- 
eases and rheumatic pains simultaneously with the appearance 
of blind piles belongs to this class of phenomena. Stahl has 
seen a dangerous miliaria follow the suppression of a varix at the 
anus. Majon has observed that deaf people are less than 
others liable to the prevailing diseases, and are more particu- 
larly insensible to the effects of great heat. I may add, from 
my own experience, that men with hernia or hydrocele fre- 
quently live to an advanced age without experiencing any 
other suffering except that which is occasioned by the local 

The relation of local to general disturbances can only be 
verified by careful observations, and the idea of a general dis- 
ease must always be more or less relative. Lobstein remarks 
with a good deal of truth : There are no general diseases in 
this sense that all the organs and systems are attacked at once. 
For, disease being a modification of the vital activity in oppo- 
sition to the condition of the individual, the extension of the 
disease throughout the whole organism would necessarily re- 
sult in its speedy destruction. The hostile morbid power in- 
vades in the first place a single organ or system ; but afterward 
the effects of that invasion extend by sympathy. Hohnbaum 
says that any disease commences at and spreads from a cer- 
tain point. A good or bad composition of the fluids, a greater 
or lesser receptivity, a higher or lesser degree of sensibility 
and conducting power of the nerves, are the causes which will 
either keep the disease within certain bounds, or else cause it 
to extend to other organs and systems. The torpidity and 
want of sensibility of a muscle will prevent inflammation or 
suppuration even if a splinter should have lodged in the parts. 


Some years ago, a laborer and my servant lopped off a few- 
branches of Rhus radicans. The latter peeled the leaves 
and squeezed out the juice without experiencing any bad effects 
from it. The former was attacked in a few hours with an in- 
flammatory swelling of the hands and face, which became cov- 
ered with vesicles, as in vesicular erysipelas. He was very 
feverish the whole of the ensuing night. 

Generally speaking those diseases spread the more rapidly 
which affect organs and systems that have naturally a great 
conducting power. If a wound of the finger should be fol- 
lowed by an inflammation of the absorbents, this generally ex- 
tends to the axillary glands. Local phlebitis generally attacks 
very rapidly the venous system at a great distance, and the 
morbid affections of certain nerves are disposed to affect the 
whole nervous system in a very short time. The recent anato- 
mical discoveries have taught us that nervous filaments dip 
into the substance of the organs, thus establishing communica- 
tions between the nerves and vessels, communications which 
enable us to account for the sympathy that exists between them, 
and causes the diseases of one system to pass at once to the 
other. As shame causes the blush to rise to the cheeks in a 
state of health, or as fright drives the blood from the peripheral 
vessels, thereby occasioning a sudden paleness; so does a vio- 
lent irritation of the nerves provoke reactions in the vascular 
system which are designated by the term " fever ;" and primary 
febrile phenomena occasion in the sensitive sphere the most 
varied phenomena of an anormal activity. 

It is known with tolerable certainty where a great number 
of diseases commence. According to Gruithuisen the start- 
ing point of the pest is the cellular tissue ; the influenza com- 
mences in the mucous membrane of the windpipe ; yellow fever 
in the secretory organs of the bile. According to Kopp several 
forms of asthma in children arise from hypertrophy of the thy- 
mus gland ; typhus abdominalis from intestinal ulcers ; a 
number of nervous affections from a slow inflammation of the spi- 
nal marrow, etc. In many diseases the starting point is re- 
vealed by the precursory symptoms ; for, as a general rule, the 
sensations of local disturbance are perceived in the spot whence 
the disease spreads in different directions. 

It has often been asked whether there are diseases not de- 
pending upon some internal disturbance of a particular organ. 
It is very difficult to answer this question, owing to the impos- 
sibility, in the present state of medical science, of establishing, 
in a satisfactory manner, the relative independence of the 
manifestations of the life of the organs ; it is very probable, 


however, that there are primitive lesions of the vital force, and 
hence also purely dynamic diseases. Admitting, however, 
that this is a fact, we cannot conclude from it that the vital 
force is instantaneously attacked in its whole extent. On the 
contrary, inasmuch as we are obliged to acknowledge a par- 
ticular life of the organs, it is more probable that the lesions 
of the vital force emanate from a fixed point, and more par- 
ticularly from the point which is most exposed to the hurtful 
external influences. A great number of accidents, such as 
general reactions of the organism consequent upon moral, im- 
material influences, convulsions and febrile paroxysms after a 
violent emotion, etc., appear indeed to result from a sudden 
invasion of the animal life in its whole extent. However, we 
know too little of the physiological importance of every part 
of the brain to refute the opinion, based upon a great degree 
of probability, that every moral sensation corresponds to a par- 
ticular organ of the brain, from which that sensation extends 
to olher regions of the cerebral mass. 

All these considerations show that it is of the utmost im- 
portance to a successful treatment, that the course of the 
disease which we are called upon to treat should be traced 
from its commencement to its least ramifications in the par- 
ticular organs ; that, in certain cases, we are able to recognize 
with certainty the existence of an isolated, local morbid affec- 
tion ; but that it is impossible, with our unsettled notions about 
the general or local character of disease to construct a system 
of nosology on that basis. 

Section 10. 

It is expedient to designate by particular names certain 
morbid conditions which are characterized by particular 

It is difficult to trace this custom, which has prevailed from 
time immemorial to its origin ; its remote date shows that it 
must have been considered necessary. It is quite natural that 
particular names should be applied to phenomena of frequent 
recurrence, in order to distinguish them from other dissimilar 
phenomena ; and it is likewise natural that the name should 
have been applied in accordance with the external form of 
the affections. The names of diseases, particularly those of 
remote date, refer principally to that which is most prominent 
in the diseases, even were this merely subjective sensations. 
Hence the different diseases which are characterized by a 


certain sensation of pain, are designated in accordance with 
both the seat and the nature of this pain ; they are called, for 
instance, cephalalgia, hemicrania, prosopalgia, angina faucium. 
pains in the back, pains in the kidneys, cardialgia, pains in 
the chest, colic, rheumatism, etc. ; or, lancinations, burning 
pains, pressing pains, tearing or ^rawing pains, cramp-pains, 
etc. At all times diseases have been moreover named by 
their predominant objective symptoms. In this way the 
fevers : jaundice, dropsy, chlorosis, vertigo, scrophulosi's, va- 
riola, rubeola, miliaria, scarlatina, erysipelas, vesicular fever, 
burning fever, intermittent fever, continuous fever, etc., have 
been formed, and it has been deemed fortunate that we should 
be in possession of names which would recall to our minds 
the idea, though only general, of the disease. 

As far as this Avent, nothing could be urged against that 
custom. Soon, however, the propriety of modifying those 
names was discussed, and all sorts of sophisms were resorted 
to in that discussion, without first agreeing on the basis upon 
which those modifications should be proposed, whether the 
external phenomena of the diseases, or their type, or what was 
considered their dynamic anomalies, should be that basis. The 
attempts to designate the different morbid conditions as correctly 
as possible by names, have been carried farther and farther, and 
have finally led to the classification of diseases in genera, species, 
and varieties, basing that classification at times upon the ob- 
jective organic, at times upon the subjective dynamic symp- 
toms of the disease. The names of the genera, species, 
and varieties thus obtained, exhibited the most striking dif- 
It is not my object to offer a complete critical review of the 
different nosological systems. Any classification based upon 
the basis above stated, has both its advantages and disadvan- 
tages. In classifying and denominating diseases by their ex- 
ternal symptoms, according to PineVs example, we consider 
merely the objective manifestation of diseases, thus escaping 
the danger of making mistakes through some incorrect idea 
of the internal disturbance. This danger threatens us, how- 
ever, from another quarter ; for essentially different diseases 
may be juxta-posed on account of certain resemblances of form, 
whereas other diseases which are closely related to one another, 
may be separated from one another. In order to obtain some 
idea of the errors which have been committed in this respect, we 
need only glance at the classification of the cutaneous diseases, 
and we will be astonished at the arbitrary manner in which 
these or those external symptoms have been adopted as a basis 


of arrangement. Bichat has attempted to arrange diseases 
according to their locality. Alibert, Good, and others have fol- 
lowed his example. The defects of this kind of classification are 
evident. Diseases of the most dissimilar character are placed 
side by side simply because they have the same seat ; other 
affections are located in the most arbitrary manner, according 
as this or that organ or tissue is supposed to be their principal 
focus. By this arrangement we are strongly reminded of 
Broussais, who considers the stomach and heart as the points 
from which all morbid irritations emanate \ — On this occasion 
we may likewise mention the sporadic typhus, which was for- 
merly supposed to belong to the class of adynamic fevers, and 
went by the name of typhus lentus ; at present it is derived 
from intestinal ulcers, because they have been discovered after 
death. I am persuaded that these ulcers do not form an es- 
sential characteristic of typhus. At this moment typhus is 
prevalent in a small village of my district ; among thirty in- 
dividuals whom I have examined with the greatest care, I 
have so far discovered three only in whom the abdomen is 
somewhat sensitive to the touch. In the remainder all the 
symptoms indicated a purely nervous disease, and symptoms 
of an intestinal affection were altogether wanting. 

To divide diseases according to their type, is likewise un- 
certain. The division of diseases into acute and chronic, is not 
founded upon any essential differences, since the same disturb- 
ance of the organism may be accompanied or not by fever, 
according as the nerves are endowed with more or less irrita- 
bility and conducting power, and are, on this account, either 
capable or incapable of occasioning sympathetic reactions of the 
vascular system. 

Fevers are principally classified according to their type. 
There is some reason in this, inasmuch as the recurrence and 
duration of the paroxysm and apyrexia constitute, as a gene- 
ral rule, the essential character of those diseases. 

If we believe that disease is an anormal vital activity, we re- 
quire particularly to consider its mode and character, and the 
best principle of classification is that which is derived from the- 
perceptible difference existing between the normal and anormat 
vitality of the part. It is upon this basis that the nosological 
systems of Hosack and Cullen are constructed. That this 
mode of classification has led to enormous mistakes, becomes 
evident by glancing at the systems of Brown and Rasori. Ira 
reviewing such mistakes we learn how easy it is to conceive 
wrong notions about the dynamic condition of parts,, as is most 
convincingly shown by the fact that the same disease has fre- 


quently to be looked for under this or that head, according as 
the author of the nosological system had this or that notion of 
the dynamic character of the malady. Typhus, for instance, 
has for a long time been arrayed under the head of dynamic 
fevers, until later observers have shown that it possesses a pe- 
culiar erethic character. Among other curious things it is sup- 
posed that intermittent fevers are simple reactions against slow 
inflammations of the respiratory organs, and that intermittent 
fever and typhus are essentially identical. 

Chronic diseases are supposed not to have any type. It is 
true that the type of those diseases is frequently entirely con- 
cealed, or can only be discovered with great difficulty. Hence 
it is that this large number of diseases has to be classed agreeably 
to one or the other of the above named principles ; even in acute 
typical diseases the classification has in many cases to be based 
upon some other character than the mere type. In this way a 
number of nosological systems have been constructed and have 
been termed " natural," simply because their authors have en- 
deavored to classify diseases according to their most prominent 
and distinct characteristics. It is evident that all those systems 
have no real objective value ; they depend entirely upon the 
view which their authors have taken of the dynamic condition 
of the affected parts, or upon what they have individually con- 
sidered the most characteristic feature of the disease. I may 
simply mention intermittent fever, which has, from time im- 
memorial, been considered a separate class of fevers, with va- 
rieties such as quotidiana, tertiana, quartana, etc. All nosolo- 
gists had agreed to consider the duration of the apyrexia and 
the frequency of the paroxysm the true characteristic of those 
fevers. At present, however, we have become acquainted with 
diseases which seem to be entirely nervous or neuralgic, and have 
nothing in common with intermittent fevers except that they 
have, like the latter, regular intermissions, that the paroxysms 
of hemicrania, prosopalgia, neuralgia oculorum, etc, set in 
after regular intervals, commence slightly, increase gradually, 
then decrease again, and have a certain duration. The difficulty 
of curing such diseases has led to all sorts of attempts. The 
supposition, for instance, that these neuralgic affections might 
be analogous to intermittent fevers, has led to the empirical use 
of Arsenic, China, and Quinine, and the success was at times 
so great that the analogy is no longer doubted. The difficulty 
then was to assign to these intermittent neuroses a place in the 
nosological systems, until the name of concealed intermittent 
fevers was hit upon. A real contradiction in terms. Such 
contradictions, however, are nothing new. Concealed piles 


have likewise been spoken of, that is to say, piles which are no 
piles ; natural philosophers have even spoken of concealed or 
latent light, that is to say, light which is no light, which Neu- 
mann thinks absurd. Schoenlein calls all these intermittent 
diseases neuroses, thus avoiding the inconsistence which we 
have censured. This combination is deserving of all the praise 
Avhich his disciples and all those who admire logical consistence 
have bestowed upon it. It is to be regretted, however, that the 
systems of nosology which have been constructed upon the above 
named so called natural principles, should have been mingled 
with uncertain hypotheses. Eisenmann, for instance, has de- 
rived the diseases termed choloses from a peculiar morbid agent 
of a narcotic nature, which he supposes causes an actual poison- 
ing of the blood. The pyroses are supposed to be occasioned 
by an agent which may be considered an oxycarburet of hydro- 
gen, or a hydro-oxyde of carbon ; the typhoses are supposed 
to depend upon an agent composed of carbon, azote, hydrothi- 
on and phosphuretted hydrogen, the only foundation for that 
supposition being Bengman's statement that he has discovered 
hydrothion gas and phosphuretted hydrogen in the atmosphere 
of typhus patient?. If we would continue in this way to let our 
fancy take its flight, we must expect to be brought back to the 
point which was occupied by Theophrastus with his Sal, Sul- 
phur and Mercurius. 

Suppose now I were asked : Has nosology been so far of 
any real use in the treatment of disease ? I should rather 
answer, No. Nosological systems might be useful, if the 
division of diseases into genera, species, and varieties, were 
made with reference to those differences which diseases pos- 
sess in common, and would therefore constitute therapeutic in- 
dications for any form of disease, like the asthenic diseases of 
Brown for instance, which remind us of the necessity of using 
stimulants for the purpose of exciting the vital action. Un- 
fortunately a considerable number of physicians, particular- 
ly among the young and inexperienced, imagine that diseases 
which are classed in the same category have to be treated in 
the same manner, in the belief that certain analogies have in- 
duced the juxtaposition of those diseases under the same gen- 
eral denomination. This error has occasioned a good deal of 
mischief, and has led Hahnemann to assert th'at it is wise 
to reject even the ordinary names of diseases, to consider every 
case of disease a distinct, independent affection, and, if any of 
the usual names must needs be used, to say at least : A kind 
of intermittent fever, a kind of dysentery, typhus, cardialgia, 
dropsy, etc., in order to express even by this mode of speaking the 


conviction that the treatment should not have reference to the 
genus, species or variety, but to the particular case before us. 
Hufeland has remarked that we might treat a disease very- 
well and the patient very badly. This assertion seems 
paradoxical, but it includes the great truth, that the most or- 
thodox treatment is not worth any thing when it is directed 
against the generic character of the disease, instead of being 
directed against the individual symptoms. A large number of 
skilful practitioners have expressed the same conviction, and 
Romberg says expressly that the name of the disease con- 
tinues still to exercise a very pernicious influence on the treat- 
ment. The disposition to generalize has occasioned enormous 
mistakes. For many diseases of children which were former- 
ly designated by the terms " convulsions or hydrocephalus," the 
collective name of encephalitis is employed now-a-days, and 
this denomination at once induces the physician to resort to 
an antiphlogistic treatment with leeches, cold poultices, calo- 
mel, thus destroying the patient who might have been saved 
under another treatment. 

It has often been remarked that the most learned physi- 
cians are often the worst practitioners ; this seems to be a con- 
tradiction, since it is impossible to know too much to practice 
medicine successfully. But to many savants we may apply 
these verses from Goethe's Faust : 

Was man nicht weiss, das eben brauchte man, 
Und was man weiss, kann man nicht brauchen.* 

Many physicians are distinguished in nosological subtleties, 
and fight against the generic or family-character of the dis- 
ease as Don Ciuixotte did against the wind-mills ; but they 
have not studied the art of understanding the gentle hints of 
Nature in the life of the individual, and to investigate with due 
attention the peculiarities of every form of disease. 

Abnsus non tollit usum. I do not mean to condemn the 
attempts which have been made to classify diseases agreeably 
to a common character, and to give particular names to the 
classes and varieties ; practitioners should not consider col- 
lective appellations of diseases fit therapeutic indications for 
special cases, and it were desirable that teachers of nosology 
would no longer present it to their pupils in such a manner as 
might lead them to select a remedy for the name of the dis- 
ease rather than for its phenomena in their true connection. 

* What one does not know, that is the very thing of which one 
stands in need of, and what one does know, one has no occasion for. 


Section 11. 

This is the place to speak 1 of Hahnemann's division of 
diseases into acute and chronic. As he had vehemently cen- 
sured the custom of generalizing diseases, and had vigorously 
attacked the old names and the innumerable hypotheses about 
the essence of disease, it must have been a matter of great as- 
tonishment to see him engage himself in a road which he had 
condemned as dangerous and uncertain. His remarks about 
chronic diseases are so peculiar, and have been attacked with 
so much vehemence by his opponents and defended with so 
much zeal by his partisans, that his opinions on this sub- 
ject are well worthy of a thorough examination, more especial- 
ly inasmuch as some of his opponents have imagined that they 
could overthrow the whole homocophathic edifice by the refu- 
tation of a single point in Hahnemann's doctrine of the chronic 

Hahnemari's opinions. 

If the most efficacious specific remedies, and which have 
been found of the greatest use in acute diseases, have proved 
less satisfactory in chronic diseases ; if those remedies have 
not so much effected radical cures as temporary palliations ; 
it is owing to the incorrect notions which we possess on the 
peculiar character of those diseases which are only incom- 
pletely revealed to us by their external symptoms. It has 
been observed that a chronic malady does not even yield to 
the strongest constitution, that it is not diminished by a regu- 
lar diet or mode of life, that it does not disappear spontaneous- 
ly, but increases from year to year, and, like miasmatic (pro- 
perly called contagious) diseases, exhibits more and more dan- 
gerous symptoms. This observation has led Hahnemann to 
suppose that all chronic diseases originate in some miasm. 

This supposition has acquired a higher degree of certainty 
by the fact that many of those who suffer with chronic diseases, 
have been affected with a scabious eruption, and we know from 
innumerable cases that the sudden disappearance or suppres- 
sion of a scabious exanthem has been followed by chronic dis- 
eases characterized by analogous symptoms in individuals who 
otherwise enjoy good health. This has given rise to the con- 
viction that the itch is the fundamental affection in which 
most chronic maladies originate. This fundamental itch is de- 
signated by the term psora, which means an internal malady 
with or without a scabious eruption. The remedies which 


Hahnemann recommends for that fundamental psora, are 
called antipsorics. The fact of these antipsorics possessing 
curative powers in innumerable chronic maladies, is considered 
a proof of the psoric nature of these diseases ; hence the con- 
clusion that almost all the cutaneous eruptions, almost all the 
excrescences, from the figwart up to the largest encysted tumor, 
from a simple deformity of the finger-nails up to the swelling 
of bones and the curvature of the spinal marrow, the softening 
and curvature of the bones, the frequent bleeding of the nose, 
the different forms of haemorrhoids, haemoptysis, haematemesis, 
haematuria, dysmenorrhea, habitual night-sweats and dryness 
of the skin, frequent diarrhoea, habitual constipation, pains in 
the joints, convulsions ; in one word, a host of chronic disorders 
which pathologists are in the habit of designating by all sorts 
of names, originate in nothing but psora. These diseases seem 
to differ all from one another ; but the similarity of a large 
number of their symptoms which are common to all, and ap- 
pear during the gradual development of the diseases, and the 
fact that all those diseases are cured by the same medicines, 
show that they have a common origin. If left to themselves 
they grow worse from year to year, until the patient dies. 
They never get well of themselves. They must therefore 
originate in chronic miasms. 

At present we know only three of those miasms, from 
which the greater portion of, if not all, chronic affections origi- 
nate ; they are syphilis, sycosis, and psora, the origin of the 

Psora is the most ancient, the most general, the most per- 
nicious, and, nevertheless, the least known of all chronic mias- 
matic diseases. Now it assumes the form of lepra, then of St. 
Anthony's fire : etc. if driven from the skin, it shows itself in 
the form of mental or nervous diseases, paralysis, consumption, 
etc. Seven eighths of all chronic diseases originate in psora, 
the remaining eighth in syphilis or sycosis, or in all three com- 

The great extension of psora is, in a great measure, owing 
to the erroneous notion which physicians had, that the psoric 
eruption was a mere local cutaneous affection not affecting 
the organism, which had to be suppressed by local remed es ; 
this was possible, provided the cutaneous eruption had not ex- 
isted too long on thy skin to be absorbed into the circulation, 
and thus to vitiate the blood and humors. Although the medi- 
cal literature offered numerous examples of the sad results 
following the suppression of the itch, yet they were not heeded; 
and even to this day the itch continues to be suppressed by 


ointments and washes, without the internal disease being 

The infection takes place in a moment's time. As soon as 
it is accomplished, washes, ointments, cauterization even, be- 
come useless ; the miasm invades in a moment the whole ner- 
vous system, as soon as a single part of it has been touched. 

Chronic miasmatic diseases do not follow the same course 
as acute contagious diseases, which disappear again in two or 
three weeks, or as the fever with its specific eruption. Chronic 
miasmatic diseases never cease spontaneously, they only change 
their form. 

In syphilis, the infection takes place instantaneously at 
the place of contact or friction, and is at once communicated to 
the whole organism. Immediately after the infection the ve- 
nereal disease developes itself in the whole organism. Nothing 
is seen for some days at the place of contact, but the internal 
organism is actively engaged in ingrafting upon itself the sev- 
eral miasms. When the internal development is completed, 
the vital force endeavors to protect the organism by forming 
a vicarious symptom of the internal disease, generally at the 
place which had been first invaded, a vesicle making its ap- 
pearance in the first place and changing to an ulcer called chan- 
cre, five, seven, or even more days after the infection had ta- 
ken place. The specific remedy, if administered internally, 
will remove the whole disease, which cannot be accomplished 
by the local destruction of the chancre. In the latter case the 
organism retains the disease as venereal miasm, which never 
disappears spontaneously. 

The same remarks apply to the itch, which is communi- 
cated much more easily than syphilis, by simply touching the 
epidermis. Every body is liable to be attacked by the itch. 
The external transparent itching vesicle is the product of the 
internal malady, which is not cured by the suppression of the 
vesicle, and which increases in violence after the vicarious 
symptom has been removed by external applications. Left 
to itself the itch forms pustules over the whole body, which con- 
tinue to increase in number and disturb the general health cor- 
respondingly. The longer the disease has lasted, the more it 
is spread in the internal organism, the more does the preserva- 
tion of the organism require the appearance of the external vi- 
carious symptom, whose suppression under these circumstances 
becomes so much the more dangerous. The pernicious con- 
sequences of such a suppression soon show themselves. In the 
recent itch, on the contrary, when the entire organism is not 
yet affected, the pernicious consequences do not make their ap- 


pearance immediately, but they nevertheless exist. The internal 
psoric malady spreads little by little, and, unless removed by 
art, continues until the patient's death, although he may appa- 
rently continue to enjoy good health for years. The symptoms 
of latent psora are often too indistinct to be recognized for 
what they are. These symptoms are more numerous in some 
individuals than in others. The most important are : 

Frequent discharge of lumbrici and ascarides, with creep- 
ing in the anus, particularly in children, frequent distention of 
theabdomen, alternate bulimy and anorexia, paleness of face and 
fiaccidity of the muscles, frequent attacks of ophthalmia, swell- 
ing of the cervical glands (scrofula), sweats about the head, 
frequent bleeding of the nose in boys and girls (seldom in per- 
sons of a more advanced age), coldness of the hands, or sweat 
of the palms of the hands, burning of the palms of the hands, 
profuse sweat of the feet, frequent numbness and going to 
sleep of the extremities, frequent spasms of the muscles of the 
extremities, jactitation of single parts of muscles, disposition to 
frequent catarrhs or dry and fluent coryzas, stoppage or pain- 
ful dryness of the nose, frequent attacks of sore throat and. 
hoarseness, hacking cough, paroxysms of oppression of the 
chest, disposition to take cold, to sprain a limb, frequent tooth- 
ache, or headache, on one side, frequent flushes of heat in the 
face which are frequently accompanied with anxiety, falling off 
of the hair, scaly tetters on the head, disposition to erysipelas, 
irregular menstruation, starting of the limbs when on the point 
of falling asleep, lassitude after sleep, disposition to sweat in 
the day-time, coated, pale or cracked tongue, frequent mucus 
in the throat, bad breath, sour taste, morning-sickness, feeling 
of emptiness in the stomach, aversion to boiled or warm food, 
dryness of the mouth, frequent attacks of cutting pain in the 
bowels, of constipation or diarrhoea, blind or flowing piles, dark 
urine, varices on the legs, chilblains, pain in the chilblains even 
without the weather being cold, or in summer, pain in the 
corns without being pinched by the shoe, disposition of the 
skin to crack, cracking of the joints in moving them, drawing 
or tensive pains in the nape of the neck, back, limbs, particular- 
ly the teeth, recurrence of the pains during rest and disap- 
pearance during movement, recurrence and exacerbation of 
the majority of the symptoms in the night, or when the ba- 
rometer is low, or during a north or northeast wind, in the 
winter or spring, vivid or uneasy dreams, difficulty of the skin 
to heal, frequent boils or panaritia, dry skin of the extremities, 
and even cheeks, peeling off of the skin in various parts, which 
is sometimes accompanied with itching and burning, vesicles 


here and there filling with pus, and occasioning at first a vo- 
luptuous itching and afterwards a burning sensation. 

A man may be affected with latent psora for a number of 
years without being inconvenienced by it, until the psoric dis- 
ease is excited by old age or by external hurtful influences ; it 
exhibits different symptoms according to the individuality of 
the patient. 

Section 12. 

The sycosic disease, which is generally compounded with 
syphilis, according to Hahnemann is a peculiar disease which 
is frequently, but not always, accompanied with a gonorrhoRic 
discharge, and is characterized by excrescences on the genital 
organs. These excrescences show themselves several days or 
weeks after the infection ; they are rarely dry and wart-like, 
more frequently they are soft, spongy and moist, readily bleed- 
ing, being shaped like the crest of a cock or like a cauliflower ; 
if destroyed by cauterization, excision or ligature (by which 
operations the external symptom, which is the vicarious 
representative of the internal malady, is alone removed), a 
secondary, much more malignant disease is the consequence. 
Either similar excrescences are developed on other parts of the 
body, or else whitish, spongy, sensitive, flat elevations make 
their appearance in the buccal cavity, on the tongue, palate, 
lips, or else large brown nodosities (tubercles) in the axilla, on 
the neck, hairy scalp, etc. Other affections may likewise result 
from the suppression of the vicarious excrescences, particular- 
ly the shortening of the flexor tendons. 

Mercury is of no avail against this disease ; it aggravates 
the symptoms, because the secondary effects of the mercurial 
treatment unite with the symptoms of the sycosic disease 
which it has been unable to control. Sycosis is the least fre- 
quent of the three chronic miasmatic diseases. 

Section 13. 

Syphilis commences the moment the infection has taken 
place, and the first appearance of chancre is an indication of 
the syphilitic disease. If this chancre be destroyedby cauteri- 
zation or desiccation, the phenomena of a general syphilitic dis- 
ease soon make their appearance in the shape of buboes, ulcers 
in the throat, etc. Syphilis is less frequently complicated 
with sycosis than psora, and if, in this latter case, it be treated 
with mercury exclusively, it is transformed into a horrible 
compound called masked syphilis, or pseudo-syphilis. 


Section 14. 

The classification of all chronic diseases under three gene- 
ral heads, psora, syphilis, and sycosis, has excited such a 
warm interest either for or against it, that we must be permit- 
ted to indulge some reflections on the manner in which it origi- 

Having ridiculed the orthodoxy of the old school ; having 
combated with a particular zeal the opinions of the iatro-chem- 
ists and humoralists as a tissue of falsehoods ; having declared 
in favor of the most rigorous vitalism, and having derided the 
doctrine of occult qualities and acrid humors, Hahnemann ex- 
cited so much more astonishment by deviating from his first 
opinions, as he had always endeavored to guard against any 
inclination of penetrating the mysteries of the internal organism, 
and had proclaimed the maxim that the objective phenomena 
are alone capable of furnishing true therapeutic indications. 
The anomalies of composition, the states of the organism 
which are generally designated by the term dyscrasias, were 
not heeded by him, although he did not absolutely deny them. 

Hahnemann appears to have been sensible of the mistake 
which he had committed in not paying any regard to the ex- 
istence of dyscrasias, and only speaking of a dynamico-spirit- 
ual influence on the totality of the animal life. The inefficacy 
of a treatment which left these material differences out of sight, 
led him to make a step backward, although he might perhaps 
not suppose that he did. He has preferred startling the world 
with the pretended discovery that chronic diseases are so invet- 
erate because they depend upon some heterogeneous agent in 
the organism, a miasm. 

In order not to recede too far from his ultra-dynamic notions 
he was obliged to start the doctrine, that immediately after the 
contact of the miasm, the contagion spread throughout the 
whole organism and produced a disturbance in the nervous 
system, which caused the exanthem to appear at the spot which 
had been first affected. In order to be consistent he denied that 
contagious diseases were originally local ; to confirm that pro- 
position he showed that the suppression of the local erup- 
tion of the itch, syphilis and sycosis, has in innumerable cases 
been the cause of a general internal malady which manifests 
itself in the most varied forms, and is much more dangerous 
than the original eruption. 

Whether Hahnemann's views in this respect were right or 
wrong, they do not affect the homoeopathic doctrine. The 


discussions on the primitive seat of these contagious diseases 
are not yet closed, and it is no more my desire to mention the 
different opinions which have been expressed on this subject, 
than to express precipitately an opinion on a subject which is 
yet under discussion. I may, however, observe that a great 
number of facts tend to show that the contagion does not al- 
ways attack the whole organism at once, that it may on the 
contrary beget a disease which is kept within bounds for a 
shorter or longer space of time, in which case the local symp- 
tom may be removed by cauterization or corrosive means 
without occasioning a general affection. 

We must admit that we have no certain indication by 
which we can determine whether the itch is still a local af- 
fection, and that we ought to avoid any treatment which 
might be followed by a secondary psoric affection. Hahne- 
mann has collected a large number of such cases from authors 
of the last century. The ancient physicians have never 
noticed any secondary psoric affections, since they treated all 
exanthematic diseases, even lepra, with external remedies, 
which were sometimes composed of very poisonous substances. 
Galenus tells us that copper, cantharides, and arsenic, were 
employed externally. Still he knew that the itch was not a 
local affection, since he supposed that it depended upon saline, 
stagnant humors. Hildanus attributes a case of melancholy 
with suppression of the menses, in the case of a young girl, to 
the sudden suppression of the itch with which she had been af- 
fected in her childhood. In Fred. Hoffmann's System of Ra- 
tional Medicine we find a number of cases of disease from 
varions ancient authors which had been caused by the sudden 
suppression of the itch, and were partly cured by the re-ap- 
pearance of the original itch. In our age this subject has ex- 
cited great attention. Wagner and Wengel have written on 
the pernicious effects of the sudden suppression of the itch ; 
Authenrieth attributes to this cause the greatest number of 
cases of phthisis. Schmidtmann has seen chronic pemphigus 
arise from a similar cause. He cured it ; but in its place ap- 
peared violent cramps of the stomach with general emaciation, 
which disappeared after the re-appearance of the exanthem. 
According to Albers the suppression of the itch is frequently 
followed by organic diseases of the heart. Elsewhere he ob- 
serves that chronic diseases of the skin frequently occasion 
diseases of the gullet, particularly strictures, indurations, ulcers, 
and that the gullet is frequently attacked with chronic inflam- 
mation while the pustules are forming on the skin. This is 
indeed, only a simultaneous sympathetic affection. Metasta- 


sis principally takes place however in organs which have sym- 
pathetic relations with one another. I have known several 
cases of affection of the throat which could only be cured by the 
use of the antipsorics.* Griesselich has seen the suppression of 
tinea, in a child of three years, followed by coxalgia, which 
disappeared after the tinea had been restored by means of 
tartar-emetic ointment. In a hunter of fifty years he has seen 
a cold with suppression of sweat followed by a herpetic eruption, 
which disappeared and was succeeded by anasarca. Nothing 
would do l he patient any good. He was finally exposed to 
the heat of the sun ; sweat broke out, the exanthema re-ap- 
peared, and the patient was well in a fortnight. I will add a 
few cases from my own experience. 

The pupil of a musician was attacked with the itch. He 
rubbed himself with an ointment of lard and metallic mercury. 
The exanthema disappeared, but three days after he was seized 
with convulsions, which lasted half an hour, and terminated in a 
spasmodic torsion of the hands and feet, which was so painful 
that he uttered loud cries. The exanthem was soon brought 
out again by the application of flannel dipped in an infusion 
of mustard, and by the use of sudorifics ; after which the con- 
vulsions ceased and the eruption was treated with more care. 

A young girl, affected with the itch, suppressed it by washes 
and ointments, sulphate of zinc, etc. The consequence was 
that she was attacked with an affection of the eyes and 
intense photophobia. After having used a large number of 
remedies without the least success, she came to me. I diag- 
nosed chronic retinitis, which was considerably diminished by 
small doses of Belladonna and Sulphur administered at short 
intervals, and which disappeared entirely in six weeks under 
the action of Phosphorus and Sepia. In proportion as the 
eyes improved, the eruption re-appeared upon the skin. 

I have frequently observed that the suppression of the itch 

* The following case is deserving of more particular mention. A 
lady of 48 years, who had been, some years before, with several children af- 
fected with itch, discovered some itch-pustules, but no general exanthem, 
upon her person, for which she did not take any medicine. For some 
time past she had been suffering with a difficulty of swallowing, which 
increased from day to day. Her throat had become narrower ; she 
had to swallow more slowly from day to day ; sometimes part of what 
she took remained in her throat, and threatened to choke her. An old- 
school physician advised her to apply a seton at the nape of her neck, 
which was, however, omitted. I gave her three doses of Sulphur, one 
every three days, followed by several doses of Graphites, one every five 
days. At the end of six weeks she was entirely well, without any exan- 
them having made its appearance. 


is followed by herpes, salt-rheum, ulcers oh the feet, oedema of 
the legs, chronic prosopalgia and phthisis. I admit that the con- 
clusion post hoc, ergo propter hoc, is very uncertain, and that 
one often sees what one expects to see. It is therefore possi- 
ble that we may frequently be induced by a preconceived no- 
tion to set down as secondary affections of the itch, diseases 
which are owing to an altogether different cause. Some of 
these diseases may have been occasioned by the very means 
employed to suppress the itch, among which we may enume- 
rate Mercury, Arsenic, Oxyde of Lead. Nevertheless the same 
diseases have so frequently been known to follow a suppression 
of the itch that we cannot help imputing them to this treatment. 
Experience shows that 

1. The suppression of an exanthem is so much more dan- 
gerous as the exanthem is more acute ; hence it is that phreni- 
tis, delirium, convulsions, set in after the sudden suppression 
of scarlatina. 

2. That the suppression of a chronic exanthem is so much 
more dangerous as the eruption has been longer on the skin 
and the suppression takes place more rapidly. 

After the suppression of the exanthem, the symptoms of 
the secondary disease frequently manifest themselves so rapid- 
ly that there can scarcely be a doubt about their character ; there 
may be a doubt when the eruption disappears slowly. It has 
been said that the irritation of the skin occasioned by the 
psoric miasm, and characterized by an itching and burning, 
must be of an inflammatory nature ; and, inasmuch as the notion 
that inflammations must be combated by bleeding has not yet 
been abandoned, scarifications and carthartics have been re- 
sorted to in the treatment of the itch, in order not to omit any- 
thing which is required by the antiphlogistic treatment. It 
is true, the patient feels soon relieved, the itching and burning 
diminish, the exanthem ceases to spread, and disappears even 
so much more rapidly as the organism has been more violent- 
ly deprived of the means of relieving itself from the internal 
disease by means of a congestive condition towards the skin ; 
but, on the other hand, secondary affections make too frequent- 
ly their appearance after such a depleting treatment, which 
cannot be accounted for. 

1 shall not endeavor to lift the veil which covers latent dis- 
eases. Are they depending upon some dyscrasia, or do they 
simply consist in a disturbance of the vital force ? We do not 
know. We only know the facts ; we know that the so-called 
latent diseases, are a disposition to certain irregularities which 
may be kept in check for years, by the good state of the gen- 


eral health, and only break forth in some positive disorder 
when the vitality of the organism is depressed by age or by 
the influence of certain hurtful causes. The phenomena of 
disease, then, make their first appearance in that part of the or- 
ganism which is weakest and therefore most susceptible. 

Section 15. 

It is well known that syphilis, when neglected, badly man- 
aged, or incompletely cured, leaves pernicious consequences, 
which frequently last during a man's lifetime, and are even 
transmitted to his children. The syphilitic miasm is very dif- 
ferent from psora, although the syphilitic exanthema might, in 
some cases, be confounded with the common itch. It is less 
volatile, and is therefore less easily communicated. Healthy 
persons may for months sleep in the same bed with venereal 
patients without being infected. The syphilitic miasm attacks 
principally the less noble organs, the mucous and serous mem- 
branes, and, in more serious cases, the periosteum and glands, 
whereas the itch, being more volatile than the syphilitic con- 
tagium, invades more frequently the nervous system, occasion- 
ing epilepsies, spasms, dementia, melancholy, or diseases of the 
organs of the senses. 

If, as Hahnemann pretends, the whole organism is invaded 
at the moment the infection takes place, there is no difference 
between primary and secondary syphilis ; in this case secon- 
dary syphilis is simply the symptoms of the syphilitic disease 
having become general, previous to which the syphilitic dis- 
ease, which was general from its commencement, was con- 
centrated within certain limits. We may, on this occasion, 
mention the revulsions by means of which the disturbances 
affecting the whole system are vicariously represented by the 
affection of a single organ. Hunter has likewise maintained 
that every chancre is the reflex of a general disease, and that 
the symptoms of general syphilis only make their appearance 
after the destruction of the local symptom. In another work 
I have related the case of a young man who had been affected 
with a chancre for four years without having done any thing to 
remove it, and without noticing any derangement in his gen- 
eral health. A few days ago I had a similar case. I was 
requested to examine a young woman of 28 years living in 
the country. She was said to be affected with syphilis. I dis- 
covered a horrible destruction caused by primary ulcers that 
spread a truly cadaverous smell ; but there was neither bubo 
nor ulcers in the throat, nor any other symptom of secondary 


syphilis. She had been affected in this way for six months, 
and had not yet done any thing to get well. Cases where 
chancres are left to themselves, are certainly rare, but even 
those rare cases show that the affection may remain circum- 
scribed within the same bounds for a long time. 

We have many examples of general syphilis occasioned 
by the destruction or desiccation of a primary chancre. But 
there are also a number of cures of primary chancre by local 
means without any untoward secondary symptoms. I sus- 
pect that most of those cures are illusory. I know, for in- 
stance, positively, that a certain physician boasts of having 
cured a chancre by lead-washes, without suspecting that the 
young man, mistrusting these applications, had been all the 
time taking corrosive sublimate by the advice of some other 
physician. The great point is to know by what means a 
primary chancre has been cured. Was it by mercury ? by 
Bellast's liquor, or by the mercurial ointments ? From these 
remedies a specific cure may be expected. As for myself, I am 
so much less disposed to deny the possibility of curing a pri- 
mary chancre by other than the above means, without any 
secondary syphilitic infection, as such a cure is frequently 
accomplished by the antiphlogistic treatment without mer- 
cury. However there are so many examples of secondary 
syphilis after the destruction of the local symptom, that this 
mode of treatment should be looked upon as a very doubtful 

Section 16. 

Until now the appearance of the sycosic excrescences has 
been looked upon as a progress of the syphilitic disease. 
Hahnemann considers sycosis a disease suigenei'is. This 
opinion is founded on many facts. There are cases of ex- 
tensive general syphilis without figwarts, and on the other 
hand figwarts without syphilis. This fact has been noticed 
by Glason in Archiv. X, 1. Newmann likewise asserts that 
the inveterate acuminated condylomata arise from a miasm 
which is different from that of syphilis, but is equally trans- 
ferable by coition. I have frequently observed condylomata 
with or without syphilis ; very lately I have treated two young 
men and a girl of nineteen, for simple sycosis. The two 
young men were in the first place attacked with gonorrhoea, 
which would not yield to the most celebrated remedies. The 
cause of this obstinacy was discovered in about a fortnight, 
where the condylomata made their appearance on the prepuce 


and glans. In the case of the young girl they had appeared 
immediately without any other symptom. They were cured 
all three in a very short time by the specific remedy, Thuya, 
which has been first recommended by Hahnemann, and the 
efficacy of which has been verified by others. Vossen of Aix- 
la-Chapelle has likewise remarked that condylomata are not 
always indications of some previous syphilitic affection. But 
have they no sort of relation to syphilis ?— Numerous obser- 
vations have shown that diseases may degenerate. A badly 
managed itch frequently leaves herpes, and if this herpes is 
communicated to others, as will take place among persons 
who sleep in the same bed, the disease retains the secondary 
form of herpes. Sycosis seems to have sprung from syphilis, 
retaining a separate form. Sycosis may however become com- 
plicated with syphilis, as well as with psora or some herpetic 
dyscrasia, and will, in this case, be so much more difficult to cure. 
Diseases belonging to the same family as syphilis offer 
many varieties. Gonorrhoea is not necessarily a syphilitic 
disease. There are three kinds of gonorrhoea which may be 
communicated by infection. 

1. Pure gonorrhoea, urethretis, with increase of the mu- 
cous secretion, which never changes to syphilis, even when 
neglected or badly managed, although it sometimes leaves 
strictures and other painful affections. 

2. Syphilitic gonorrhoea, with accompanying syphilitic 

3. Sycosic gonorrhoea, which is distinctly recognized only 
by the accompanying condylomata. 

The difference of opinion which prevails on this subject, 
arises from the fact that these three kinds of gonorrhoea 
have been confounded with one another. This mistake is so 
much more unpardonable as the success of the treatment de- 
pends upon this distinction. Gieil has seen tubercles appear- 
ing after a mismanaged gonorrhoea; according to Autenrieth 
and Ritter such tubercles are incurable. I presume that these 
tubercles were of a sycosic nature, and that they might have 
yielded to Thuya and nitric acid. 

Section 17. 

This is the place to examine the question : Is there a la- 
tent syphilis? By a latent or disguised malady I mean a dis- 
ease whose internal nature is not distinctly recognized by its 
external phenomena. This is doubtless the case with some 
forms of syphilis, and it is needless to mention cases in proof 
of our assertion. But here another question presents itself, 


which is more difficult to solve : Can syphilis exist in the or- 
ganism without manifesting its presence by morbid phenomena? 
The nature and properties of a contagium and its mode of 
action are as yet unknown to us. What little we know of it 
is altogether empirical ; experience has simply revealed to us 
the fact that thecontagious virus of acute diseases manifests its 
effects upon the organism very speedily. After the inoculation 
of the small-pox small blotches make their appearance on the 
third or at latest on the fourth day. Chronic contagia show 
their effects after a longer and irregular interval. Of two 
young men who were infected by the same woman, in the 
same night, and in the same bed, one perceived the symptoms 
of the infection on the third and the other on the eleventh day. 
The period when the rage breaks out after the bite,* is still 
less uncertain. The causes of this difference are not seated in 
the contagium, but in the organism, which reacts sooner or la- 
ter. If it be possible that a contagium should remain latent in 
the organism, it must also be possible that the disease which 
springs from that contagium should make a pause in its de- 
velopment, during which the condition of the patient resem- 
bles that which existed between the moment of the infection 
and its first external appearance. The interval between these 
two periods being of an uncertain duration, the pause which 
the disease makes in its course may likewise be more or less 

I have never seen a case of latent syphilis or psora left to 
itself; what I know on this subject refers to cases which had 
been cured, and where the eruption appeared again afterwards. 
Doctor of Berlin has published some remarkable cases 
of latent or disguised syphilis in Hufeland's Journal. After 
having been slumbering for years the disease manifested itself 
under different forms, for instance as blepharopthalmia, iritis 
with contraction of the pupils such as is peculiar to syphilitic 
iritis, hemiplegia, insomnia, cephalalgia, amaurosis, violent 
rheumatism, epilepsy with dorsal consumption, hepatitis, pneu- 
monia, etc. Walther has seen caries of the cheek and a poly- 
pous excrescence of the bladder appear, after a state of health 
of 12 years, in an individual who had been cured of a chancre 
by corrosive applications. 1 know cases where men who had 
been syphilitic, and who had enjoyed perfect health for 
years after the removal of the disease, have communicated 
to their wives a disease characterized by erosions in the vagina 
with corrosive leucorrhcea. One of them has had a son, who 
shortly after his birth, was attacked with flat, fetid ulcers on the 
scrotum and under the arms, and who died of atrophy. The 
father continued in good health for some years, when he was 


frequently attacked with strangury. The mother was cured 
by Thuya and nitric acid. An imperfect cure, a simple neutral- 
ization of the syphilitic or sycosic contagium had probably 
been effected in those cases. It appears that the organism can 
gradually accustom itself to the irritation of the modified mor- 
bid principle to such a degree that no sensible reaction is per- 
ceived in the organism, although it may constantly possess the 
power of communicating the infection to others. Thus it is 
that herds of cattle from Podolia, even when in a state of per- 
fect health, spread the anthrax in those foreign countries 
where they are transported, and that in the court of Oxford 
the prisoners whocame outof the dungeons filled the hall with a 
smell of corruption, which caused a fatal putrid fever in all 
those present, although the prisoners themselves remained 

Section 18. 

Athough a large number of chronic diseases originate in 
psora, syphilis and sycosis, yet this does not justify the in- 
ference that these are the only sources of chronic maladies. 
Hahnemannn's reasons for restricting the origin of chronic 
maladies to those three miasms are the following : 

1. The universality of the itch. This cannot be denied, and, 
since I have observed it more closely, I have been astonished 
to find that so many men are attacked with it. A large num- 
ber of families, however, have never had the itch, particularly 
in the higher order of society, where there is more cleanliness 
and less contact with other people. Nevertheless those fami- 
lies suffer with chronic maladies ; the supposition that these 
spring from some previous, unnoticed contact with itch-patients 
is indeed probable, but nevertheless too hypothetical to be con- 
sidered a sufficiently sound basis for Hahnemann's theory. 

2. The resemblance existing between the symptoms which 
generally make their appearance after the external suppression 
of the itch, and the symptoms of chronic maladies. There is 
scarcely any form of disease which has not been supposed to 
spring from suppressed itch. Supposing even that the re- 
semblance is as general as is supposed, it would be an im- 
proper stretch of logic to infer that all chronic diseases origi- 
nate in psora. We might just as well suppose that, because 
the indigo tinges blue, all blue colors come from the indigo. 
As certain it is, however, that there are many blue colors be- 
side the indigo-blue, as certain it is likewise that a great many 
chronic diseases, even cutaneous eruptions, spring from other 
causes than psora. Bate?nann, for instance, describes a ca- 


chectic itch observed among sickly children, and even adults, 
when their constitution is broken down by some other chronic 
or by an acute malady ; this itch is not contagious, which 
would be the case if it were of a psoric nature. Girtanner relates 
that hundreds of poor children from the county of Derby, who 
are brought up with oatmeal, are attacked with a slow scrofu- 
lous disease, and either die or else live in a wretched state of 
weakness. A large number of women come to Giessen to be 
confined in the lying-in hospital of that place, after which they 
place their infants with nurses in the city or country ; I have 
frequently observed that these little creatures, from want of 
cleanliness and good food, are attacked with atrophy and en- 
largement of the abdomen, a cutaneous eruption frequently 
supervening. It would seem as though the cause of this de- 
cay should be attributed to the want of care, without seeking 
any more remote causes. 

3. The obstinacy of chronic maladies cannot well be ac- 
counted for except by the presence of some miasm. Hahnemann 
admits, indeed, that there are many chronic conditions which 
are similar to those described by him, although they result from 
different causes, particularly from irregularity of diet or from 
some external noxious influence ; but he does not consider 
such conditions chronic, inasmuch as they may cease of 
themselves as soon as the cause is removed. This is some- 
times the case, but not always. Incipient atrophy may be 
cured by simply improving the diet and mode of life of the 
child, by giving it small quantities of light and nourishing food 
and keeping it clean. But if atrophy becomes chronic, if tu- 
bercles have formed in the mesenterium, diet alone is not 
sufficient, and the cure will be slow, even with proper treat- 
ment. Are there not many obstinate chronic diseases which 
do not originate in psora, such as dorsal consumption brought 
on by venereal excesses, dropsy occasioned by excessive bleed- 
ing, hypertrophy and induration of the spleen from abuse of 
cinchona in intermittent fever, the mercurial diseases of miners 
and looking-glass makers, the phthisis of stone-cutters, the hy- 
pochondria of savants, the hysteric diseases of delicate females, 
and those numerous nervous diseases caused by moral influ- 
ences and frequently incurable, melancholy, epilepsy, etc. As 
we understand by chronic diseases all those which do not run 
through a regular course, we cannot admit the arbitrary clas- 
sification of Hahnemann, who excludes from the number of 
chronic diseases all those which do not originate in one of his 
three miasms. It is likewise untrue that the diseases which 
he terms chronic never get well of themselves. 1 know seve- 


ral families where the children were affected with scrofulous 
symptoms, glandular swellings, eruptions, etc., all of which 
have disappeared afterwards. A large number of anormal con- 
ditions disappear at the age of pubescence, and a predisposi- 
tion to phthisis frequently disappears after the age of thirty. 
Nature is frequently more powerful than art. 

4. The cure of chronic diseases by the antipsoric remedies. 
This proof is the weakest of all. If the itch and all chronic 
disorders were cured by one or several remedies, Hahnemann 
might be somewhat justified in supposing that most chronic 
diseases originate in the itch. It happens, however, that the 
antipsorics do not cure the itch. It might be asked : What 
right has Hahnemann to call these remedies antipsoric ? The 
only answer to this question is that he has denominated them 
antipsorics in accordance with the hypothesis that most chro- 
nic diseases originate in psora, and that those diseases are cured 
by the remedies called antipsorics. A number of chronic dis- 
eases, however, yield to other remedies than the antipsorics. 
Besides, it is illogical to infer an identity of forms from the fact 
that one and the same remedy cures different diseases. Even 
if diseases have any thing common in their origin, as is the case 
with encephalitis, croup, and syphilis, which have an inflam- 
matory character, the resemblance is altogether too general to 
constitute identity, unless the genera, species, and varieties of 
all sorts of diseases are to be considered identical. Sophisms 
of this kind have frequently been indulged in, because in the 
first place, nosological generalizations have been carried too far, 
and, in the second place, because the fact that every remedial 
agent affects the organism in different ways, has not been 
properly considered. One and the same remedy may excite 
the activity of one system, diminish that of another, and may, 
in this way, manifest curative effects of an opposite nature, 
provided the systems and organs upon which the remedy is 
intended to act, are in opposite polarity. Hence it may be 
readily understood why the same remedy removes morbid 
states which are characterized by the most dissimilar symp- 
toms. Calomel, for instance, at times induces vomiting, at oth- 
ers diarrhoea, at times salivation, and then again a copious 
secretion of urine ; it frequently stimulates the activity of the 
internal absorbents, resolving indurations of the liver, glandu- 
lar engorgements, causing plastic effusions to disappear, curing 
hydrophobia and other nervous or inflammatory diseases. At 
other times calomel is employed for rheumatism, and, if used 
for any length of time, it frequently excites a mercurial ery- 
thema on the skin. Who would undertake to assert that all 


those diseases are identical because they frequently yield to 
calomel 1 

Section 19. 

Although the psora doctrine of Hahnemann is too sweep- 
ing a generalization, yet it has had considerable influence on the 
development of the specific method of treatment, and has led to 
the discovery of truths which have long remained hidden 
from the eyes even of the most devoted partisans of Hahne- 
mann's doctrine. 

These truths are : 

1. Although the animal life, in its highest form and develop- 
ment, seems to be endowed with regulating powers, yet it can- 
not be denied that the vegetative system exercises a reactive in- 
fluence on the vital functions. Either of the three principal man- 
ifestations of vitality may be morbidly affected, which is prin- 
cipally the case with the vegetative sphere for this reason, that 
the exchange of matter between the organism and the external 
world is going on uninterruptedly. 

2. We know from experience that organic lesions in 
the reproductive system may, in many cases, be directly act- 
ed upon by remedial agents with a view of correcting the 
anormal composition of the affected part. Such agents do not 
act chemically, since chemical action is subject to the laws of 
vitality ; but they determine the vital force to react principally 
in the direction of the reproductive sphere, they direct the pro- 
cess of exchange of matter, and so modify both the quantity 
and the quality of the secretions. These agents therefore act 
dynamically, although affecting more directly the local disor- 
ganization than other dynamic remedies which affect princi- 
pally the sensitive and irritable sphere, although likewise pro- 
ducing local changes which are, however, too delicate to be per- 
ceived by the senses. From a dose of sulphuric ether, for in- 
stance, we perceive a general acceleration of the vital functions, 
whereas mercury seems to affect less the vital functions than the 
secretory process, occasioning perceptible local alterations in 
the secretions themselves. 

Hahnemann having become convinced that it was essential 
to observe with due care the local changes supervening in a 
variety of morbid conditions, he expressed his testimony to 
that effect in his psora doctrine, which has indeed dazzled a 
number of his disciples, but, on the other hand, has induced 
many ardent admirers of the homoeopathic healing art to de- 
vote all their efforts to the development of true pathogenetic 


The truth is that there are a great many diseases the invet- 
erate character of which is owing to a disturbance of the vital 
action of the vegetative sphere, whence spring anomalies of 
composition which are generally designated by the term dys- 
pasias. It is likewise true that syphilis, sycosis and psora 
occasion many diseases, and that diseases which are occasioned 
by a miasm, unless radically cured, frequently leave a morbid 
principle in the organism which manifests itself in different 
forms ; but it is also true that diseases greatly resembling one 
another and exhibiting the known form of dyscrasias, frequent- 
ly arise from other causes, and are extremely obstinate without 
originating in a miasm. 

It. is therefore incorrect to apply the term antipsoric to all 
those remedies which cure chronic non-syphilitic or non-syco- 
sic diseases. In a therapeutic point of view the name, it is true, 
is indifferent ; but it is not indifferent to have false names which 
may lead to the adoption of the false notions which these names 
embody. The term "antipsoric" should be abandoned ; it is 
of no avail, and may become a source of mischief. By those 
remedies, we understand remedies which are more particularly 
intended to remove anomalies of the vegetative sphere and of 
the composition of organs. The object of those remedies being 
the substitution of eucrasia for dyscrasia, they might be pro- 
perly called " eucratic remedies." 

Section 20. 

The division of diseases into acute and chronic is of very 
little use in practice. Even if all should agree on the meaning 
of fever, (which is unfortunately not the case,) it is pretty gen- 
erally admitted that fever itself is not the object of the treat- 
ment, since, as Jahn remarks, fever is not the disease but its 
shadow, that is to say, a sympathetic disturbance of the vas- 
cular system occasioned by some primary local affection. The 
question whether there is any essential primary fever, has not 
yet been resolved, and will not be until the other question is 
solved, whether there are local diseases. A large number of 
phenomena seem to show that certain conditions of the blood 
may excite general reactions of the vascular system, or what 
is called a pure vascular fever; and, inasmuch as the blood 
circulates through the whole body and the diseases of the 
blood may therefore be considered general, the admission of 
essential fevers is by no means objectionable. It is yet doubt- 
ful whether the alteration of the mass of blood which we 
suppose is formed in the capillaries, arises from a general 


disturbance of the metamorphosing process, or, which is more 
probable, from some local affection of the existence of which 
we have as yet no positive evidence. This is the reason why 
the treatment of all so-called essential fevers is purely symp- 
tomatic. Our object in treating such a fever is, to remove the 
reaction against something unknown ; whereas in every other 
form of fever, the treatment is directed against the fundamental 
affection whence the fever arises. Hence we distinguish in- 
flammatory fevers, suppurative, gastric, hectic fevers, etc. ; 
and, if we mean to pursue a rational treatment, we proceed 
not so much against the fever as against its causes, the discov- 
ery of which is sometimes the touch-stone of a good diagnos- 

Section 21. 
Disease becomes manifest by reaction, the same as life. 

Great confusion has arisen from the notion that disease is 
something abstract, something heterogeneous, against which 
the organism reacts ; in distinguishing, in accordance with 
that notion, the symptoms of the disease from those indicating 
the reaction, cause and effect are confounded with one another. 

No individual life can exist without the contact of the 
external world. For life is not the inmost power ; it is the 
activity and existence through this inmost power. This power 
it is which reacts against the macrocosm. The reactive process 
takes place in the organism, and is therefore an anormal con- 
dition of the organism's own life, but not of a different life. 
The phenomena which characterize the process of reaction, take 
place agreeably to the laws of the organic vitality. Now, if 
disease be a mere modification of the organic activity, or, in 
other words, an alteration of the reactive process, it is impossi- 
ble that the organism should react against its own reaction. A 
careful analysis of the pathological process gives us a still 
clearer insight into that subject, and leads to the following 

Death ensues instantaneously when hurtful influences act 
upon the organism in such a manner as will attack it at once 
in every part, and cause a general disturbance of the conditions 
upon which the individual life depends. Disease arises from 
a more or less local primary disturbance, manifesting itself at 
times by a derangement of the functions, at others by a de- 
rangement of the sensations, as in neuralgia, and being recog- 
nized by more or less distinct symptoms according as the 


affected organ is more or less important, or more or less sensi- 
tive. The organism being a unit composed of different parts, 
the local disturbance must necessarily affect every part of the 
organism, though at different degrees. This difference depends 
partly upon the nature of the general sensibility of the organ- 
ism, and partly upon the nature of the affected organ, upon the 
greater or less intensity of its nervous life, and upon the fact of 
its being a conducting agent, as is the case with the canals 
through which the blood courses or other fluids are trans- 

The morbid sensations, or the functional derangement, of 
certain organs at a distance from the primarily invaded part, 
are termed sympathetic symptoms; the pain in the shoulder, 
for instance, which is a concomitant symptom of hepatitis, 
arises from the conducting property of the nerves, and is a 
purely sympathetic pain. A whole system may react sympa- 
thetically : convulsions, tetanus, trismus consequent upon a 
lesion of the tendons ; febrile paroxysms, tumultuous move- 
ments of the heart and the whole vascular system in conse- 
quence of a primary affection of the nerves, are sympathetic 

The subtlety has been carried so far as to distinguish the 
symptoms of the disease, and symptoms of symptoms. These 
latter, however, cannot be any thing else except a farther de- 
velopment of the disease, or a manifestation of the same affec- 
tion in other parts than those which had been primarily 

It is very natural and convenient, however, to distinguish 
idiopathic and sympathetic affections. The former claim our 
principal attention, for if they are removed, the latter frequent- 
ly disappear of themselves. Sometimes it is very difficult to dis- 
tinguish those two kinds of affections, because the idiopathic 
affections, when seated in organs that are poorly provided 
with nerves and are therefore endowed with little sensibility, 
are less distinct than the sympathetic affections, which are 
sometimes perceived sooner than the former. The sympathetic 
pain in the shoulder is frequently more quickly perceived than 
the affection of the liver which had given rise to it; the pain 
in the knee is perceived sooner than the affection of the hip- 
joint which is the cause of the spontaneous limping; and the 
vertigo, which is induced by the gastric derangement, is felt 
sooner than the more characteristic symptoms of an indiges- 

By symptoms we understand the totality of the symptoms 
of an idiopathic disturbance, as characterizing the reaction of 


the organism against the morbific influence. What is termed 
symptoms of the reaction refers to the sympathetic affections : 
this denomination is incorrect, unless we understand by it 
that reactions take place in different organs by sympathy. 
Reactions against the disease can only be understood when the 
disease is represented as a local disturbance exciting reactions 
in other organs or systems, so that one organ reacts against 
another. The individualizing physician should consider all 
those phenomena of reaction as belonging to the disease, and 
the only distinction is between the idiopathic and sympathetic 
affection, the latter of which may be very different in different 
organisms (from reasons which we have shown above), al- 
though the symptoms may originate in the same cause. We 
shall hereafter speak of the reaction of the organism against 
the primary effects of external agents. 

Section 22. 

The reaction of the organism against external influences 
is of different kinds. 

Medicine would become the most wretched empiricism, if 
we were guided in the exhibition of our remedies by no 
other principle than because they had been found efficacious 
in certain cases of illness characterized by similar symptoms, 
and if we would not inquire into the cause why those remedies 
had produced salutary changes. But, since disease is simply 
a modified vital state, we have to apply to physiology in order 
to ascertain under what circumstances those changes take 
place ; the discovery of those circumstances will lead us to the 
development of a physiological pathology which will at the 
same time be the basis of a true system of therapeutics, and 
will indicate the course we have to pursue in the treatment of 
disease. This shows that it is of the utmost importance to 
know how disease originates. 

The effect which external influences exercise on the liv- 
ing organism, provided that effect is not purely chemical and 
therefore destructive oflife, depends partly upon the nature of the 
external agent, and partly upon the degree of susceptibility man- 
ifested by the organism. The activity which is excited in the or- 
ganism by the action of external influences, is generally termed 
reaction. We are so much in the habit of confounding the reac- 
tive powerof the organism with its vital power, particular 
mention is made of the latter in speaking of the modifications 
which certain external influences excite in the manifestations 


of the organic life ; we content ourselves, on such occasions, 
with designating the external agent as the cause of those mod- 
ulations. We express ourselves in this fashion : This thing 
is heating, cooling ; it is a cathartic, sudorific, etc.; having refer- 
ence merely to the result produced, the increase of heat, cold, 
alvine discharges, perspiration. Physiologists and psychologists, 
however, use such expressions with reference to the reactive 
power of the organism ; their object is to determine the relation 
of that power to the external agents or stimuli, with a view of 
measuring the different degrees of reaction both quantitatively 
and qualitatively. Our knowledge of the quantitative nature of 
the reactions of the organism is purely empirical ; we know too 
little of the laws of life to account for the quality of those reac- 
tions. We know from experience that Ipecacuanha occasions 
vomiting, that Rhubarb relaxes the bowels, that Morphine lulls 
one to sleep, and that Sambucus excites the perspiration. In ob- 
serving the form of reaction we have arrived at a general per- 
ception of the principle of dualism, which leads us to suppose 
that the substances which excite a peculiar action in certain 
organs, hold certain polaric relations to those organs which 
we are as yet unable to designate more particularly. 

Every animated individual is endowed with an inherent 
tendency to maintain its integrity in the contact with the 
external world, in which it succeeds, more or less completely, 
according to the measure of its reactive power. These quan- 
titative differences of the reactive powers of the organism de- 
serve to be more particularly inquired into. 

Section 23. 

Among the different kinds of reaction on the part of the or- 
ganism against external influences, we distinguish : 

1. Direct and entire opposition to those influences. 

The organism opposes them in order to maintain the integ- 
rity of its sensations and functions ; it endeavors to destroy 
the noxious influences by which it is threatened. To oppose 
those influences successfully, the organism, or at least those 
parts of it which are immediately exposed to the hostile agents, 
must be endowed with a fullness of vital energy. If the vital 
force and the external influence are equally powerful, they ex- 
cite each other into a state of tension which exists wherever 
opposite forces neutralize and equilibrate each other. There 
are vigorous organisms that can expose themselves to a va- 


riety of hurtful influences without being disturbed by them. 
In most organisms, however, the vitality of the single organs 
differs in degree, rendering certain parts of the organism more 
liable to disturbances than others. In one the vitality of the 
digestive organs is so powerful that the grossest violations of 
diet do not injure him, whereas the least cold may make him 
sick. Another exposes himself, dripping with sweat, to a cur- 
rent of air, without suffering any inconvenience from it, where- 
as the least chagrin will give him a bilious fever. The more 
the vital force is, in its fullness, equally distributed throughout 
the whole organism, the more successful are the efforts of the 
organism to maintain its integrity against hostile influences. 

There are constitutions whose equilibrium is not easily 
disturbed, on account of a want of susceptibility on the part of 
the organism to external influences. It does not follow, how- 
ever, that this organism must, on that account, possess a vast 
amount of vital energy. It is insensible to such influences, 
and is therefore very little disposed to reactions. This defi- 
cient receptivity is peculiar to torpid natures, where we frequent- 
ly notice a predominant reproductive activity, a well-fed body 
endowed with great muscular power, but on the other hand a 
phlegmatic, peaceful disposition, and a limited development of 

This is a proper place to insert a few remarks on idiosyn- 
crasy. By idiosyncrasy we understand a peculiar degree' of 
susceptibility in different individuals, to certain external influ- 
ences. Idiosyncrasy may either be general or limited to single 
organs, and may depend either upon an excessive sensitiveness 
or torpor. Such idiosyncrasies either induce violent reactions 
against particular external objects, or else there is a perfect 
absence of reactions where they would be experienced by any 
other being of the same class. If the odor of a rose induces 
syncope in some persons ; if the exhalations emanating from a 
cat cause anguish and palpitations of the heart ; if the smallest 
dose of camphor occasions sickness of the stomach and vomit- 
ing ; if a large dose of rhubarb, instead of affecting the bowels, 
induce a profuse perspiration and a copious secretion of urine: 
all that we can say in relation to those phenomena is, that 
they exist without being able to ascertain their cause in the or- 
ganism. We do not explain any thing by designating that 
cause by the vague terms of specific irritability or specific in- 
sensibility. These phenomena are however too important to 
a physician to be passed silently over. 


Section 24. 


If the organism be neither insensible to noxious influences, 
nor capable of resisting entirely the hostile influences of the 
externa] world, there will be 

2. Reactions differing from those of the vital force in its 
normal state. 

There are external noxee which appear to attack a whole 
system at once (for the local affection spreads too rapidly to be 
perceived) , and where the general disturbance is afterwards re- 
flected again in one or the other organ. I may mention alco- 
hol as an instance. When swallowed it excites in the first 
place the nerves of the buccal cavity down to the stomach ; this 
irritation soon affects the whole nervous and vascular system, 
and finally causes various local disturbances, vertigo, epistaxis, 
haemorrhoids, jactitation of single parts of muscles, etc. according 
as this or that organ shows a particular disposition to reflect 
the general irritation. The majority of noxious influences, 
however, exercise a more marked primary effect upon a single 
organ. In scarlet fever, for instance, the throat is affected be- 
sides the skin ; in the measles the mucous membrane of the re- 
spiratory organs and eyes. A large number of substances 
which are inhaled in the shape of gases, absorbed by the sur- 
face of the body, or incorporated in the organism by the stomach 
and intestinal canal, or which affect the organism by their 
mere contact, produce analogous disturbances in the functions 
of certain organs or in a whole system, if the vital force, strug- 
gling for its integrity, although strong enough to repel the 
chemical influence of the external agents, be too weak to resist 
their dynamic action. This conflict results in reactions, the 
external manifestations whereof indicate to us the nature of 
the disease. 

Section 25. 

The duration of the primary hurtful effects of external 
agents, and hence of the diseases themselves, is extremely va- 
ried. The continuance of the morbid condition requires 

(a) A continuance of the external morbific agents. 

Many of these, whether spiritual or material, are merely 
temporary ; for instance, a fright, chagrin, sudden cold, an indi- 
gestible article of food, intoxication, a stroke of the sun, an 



excessive exertion, watching, a volatile miasm which soon be- 
comes extinct, although it may excite violent temporary reac- 
tions, such as the contagium of small-pox, scarlatina, measles, 
etc. The pendulum which has been set in motion by a touch 
of the hand, will soon cease to vibrate provided it is not touched 
again ; in the same manner the equilibrium of the organism is 
soon restored by the vital force, provided this has not been too vio- 
lently disturbed. In such cases the duration of the disturbance 
depends upon the condition of the vital force generally, or upon 
the inherent vitality of the affected organ in particular. Upon 
these circumstances depend likewise the difference in the dura- 
tion of the acute contagious diseases, and the frequent increase or 
decrease of the duration of the single stages ; whence we may 
infer that the duration of the disease is not determined by the 
disease itself. 

Other morbific causes are so permanent or recur so fre- 
quently that they represent a continuous series of noxious in- 
fluences, which make it impossible for the organism to free 
itself from the disturbance it had suffered. Such influences 
are, for instance, grief, care, jealousy, daily quarrelling, un- 
healthy climate, sojourn in clamp air, or in houses which are 
exposed to currents of air, excessive heat or cold, inhalation of 
hurtful vapors, gases or fine dust, bad food, food or drinks 
which are absolutely deleterious, excesses in eating or drink- 
ing, irregular sleep, excesses of any kind, etc. 

Some individuals are endowed with such a powerful vitali- 
ty that they can gradually accustom themselves even to the 
use of poison without being affected by it. Mithridates had 
accustomed himself to the daily use of poison to such an ex- 
tent that it had lost all effect on his organism, and that he had 
to destroy himself with his sword. Strong constitutions are 
acclimated much more rapidly than weakly, and a variety of 
pernicious influences lose their power if the organism be strong 
enough to get used to them. 

Strangers are soon affected with goitres in those parts of 
Switzerland where the disease is endemic, although the 
difformity does not remain in all cases. Many are cured by 
the use of specific remedies. Sometimes the affection reappears, 
and finally stays away on account of the patient having become 
used to the climate or the water. In all cases, however, where 
the vital forces are constantly overpowered by the external 
noxious agent, a cure is impossible as long as the patient re- 
mains exposed to the morbific cause. 


Section 26. 
The continuance of a morbid condition depends 

(b) Upon the continuance of the internal cause. 

It is inconceivable that the truth of the axiom " causa remota 
cessat effectus" should ever have been disputed. Those who 
deny this proposition, have failed in perceiving the true cause 
of disease. It has been observed that diseases continue even 
when the external morbific agents no longer exist. The rheu- 
matism continues even when the current of air which had 
occasioned it, ceases to affect the organism. The epileptic fit 
after a fright, the inflammation of the brain after a stroke of the 
sun, the bilious fever after chagrin, continue after the exciting 
causes have passed over. But there is still an internal cause 
of disease, an alteration of the organic relations which had 
been occasioned by the external morbific causes, and now con- 
tinue to keep up the disturbance. Bearing this truth in mind 
we shall guard against the mistake of confounding the inter- 
nal proximate cause of the disease with the disease itself, or 
with what has been termed the essence of the disease. The 
proximate cause is the real object of cure, and must necessarily 
vary on account of the variety of the forms of disease. This va- 
riety may be reduced to two principal divisions : dynamic 
and somatic jiiseases. 

Section 27. 

The dynamic alteration or violation of the vital force 
may be of various kinds. 

(a) The vital force may be equally impoverished throughout 
the organism. A man in that condition does not exhibit any par- 
ticular symptoms of disease ; he is simply said to be weak, as in 
marasmus senilis, where life gradually becomes extinct even in 
the absence of external morbific causes. The internal vitality 
has been consumed and ceases, as the lamp would cease to 
burn from want of oil. This adynamic condition is not alone 
met among old people. It may be hereditary, it may result 
from poverty and misery, from poor diet, excessive exertions, 
watching, wasteful expenditure of strength ; or it may remain 
as a consequence of some severe disease, where the vital force 
had been so completely exhausted by violent reactions that its 
restoration became impossible. Although such an adynamic 


condition may not be characterized by any definite morbid 
symptoms, yet it is a painful state of weakness, an anormal 
condition of the organism, and, as such, is liable to medical 

(b) A disproportionate distribution of the vital force among 
the single tissues and organic systems is of more frequent oc- 
currence. This may either be hereditary or acquired, and is 
extremely varied. Each of the principles of vitality may 
either be anormally excited or depressed. The reproductive 
power may either be too active, or too weak to prevent a state 
of general atrophy. Sensibility is at times excessive, at others 
depressed, occasioning too acute or too feeble sensations from 
external impressions. An excess of irritability manifests itself 
by too violent, a deficiency of irritability by too feeble reactions. 

There are few beings in whom the vital force is not more 
or less unequally distributed among the different organs and 
systems. An excessive action of the vegetative principle 
causes hypertrophy or atrophy of single parts. The secretion 
of bile, saliva, gastric juice, semen, mucus, is at times too pro- 
fuse, at others too scanty. We perceive frequent differences of 
sensibility in the cerebral, ganglionic and peripheral nerves, and 
likewise among the organs of sense. The hysteric female 
may faint from the sight of a drop of blood, from the noise of a 
;araraed door, from the smell of musk. Differences of irritabil- 
ity may at times occasion palpitation of the heart, at others in- 
termissions and collapse of pulse, tonic and clonic spasms, etc. 
An alteration of the true dynamic relations indeed takes place 
in every disease ; frequently, however, it is merely temporary, 
and disappears of itself. In many cases it is constitutional, 
and occasions either protracted or incurable sufferings. 

Section 28. 

The continuance of a disease frequently depends upon 
anormal local changes. 

It is not my intention to trace all bodily changes to a dy- 
namic cause; I simply wish to examine the consequences 
arising from the reaction of those local changes upon the vital 
functions. Anormal formations are either congenital or ac- 
quired ; frequently they remain after other, particularly after 
inflammatory diseases, where the plastic functions are particular- 
ly excited, and are therefore apt to occasion hypertrophies, ad- 
hesions, indurations, contractions of cavities and canals ; some- 
times the anormal reproductive process leads to opposite results, 
desiccation, softening of organs, etc. Many defects of this kind 


are obviated by a restorative reproductive process ; others, by 
the fact that the function of the disabled organ is vicariously car- 
ried on by some other organ, as in the case of an obliteration 
of large blood-vessels where some anastomosing vessel is dilated 
by the current of blood and conducts it onward, or as in the 
destruction of one kidney, after which the other kidney enlarges 
and is enabled to secrete the necessary quantity of urine alone, 
etc. There are also anormal formations which remain the 
whole life, occasioning painful sensations and functional dis- 
orders. Many of those defects become known only after death, 
and then account for the unsuccessful treatment of the appa- 
rent disease. These occult anormal alterations frequently de- 
pend upon a congenital disturbance of the reproductive activi- 
ty, or upon some external deleterious influence, or lastly, they 
may remain as consequences of some other disease, particu- 
larly of a chronic exanthem. Hohnbaum mentions with great 
correctness that many chronic diseases are consequences of 
acute disorders, from which they arise either directly or indi- 
rectly, in consequence of the alterations which the acute disease 
had occasioned in the structure, texture, or functional activity 
of one or more organs. Sometimes an acute disease terminates 
critically in a chronic disorder. In other cases the chronic 
disease is simply a continuation of the acute disorder, as am- 
aurosis after typhus, asthma or hydrothorax after pneumonia. 

Section 29. 

Another cause of the continuance of a disease is the absence 
of a dynamic resistance. 

Many things in life would occasion a disturbance of the 
normal activity of the organism, if circumstances or art did not 
create some counterbalancing influence. In investigating the 
fact why certain anormal relations do not occasion any disease, 
we shall be led to observe that things which are capable of pro- 
ducing morbid states, are likewise capable of removing them. 
I can here offer only a few illustrations in reference to that 

Many men continue well only as long as they remain in a 
region where the climate, though injurious to others, seems to 
act as a preservative of their own health. Many persons who 
lead sedentary lives, would get sick if they were to suffer all 
the exposures of a stage-driver, and this one feels probably 
well only because his torpid nature requires such violent con- 
cussions. Such constitutions thrive under the effects of brandy 
which would ruin the majority of men. There are individuals 


who do not feel well and digest badly, if they are deprived of 
chagrin ; a fit of anger restores the harmony of their functions. 
Their illness probably arises from an adynamic condition of the 
liver with the acholia, which is suspended for a time by a vio- 
lent irritation of the biliary system. I have known a young 
lady who seldom spent a few weeks without being attacked 
by a species of nettle-rash, but never had a symptom of it du- 
ring the season of sweet- water crabs, of which she consumed a 
large quantity. It is well known that crabs occasion such 
eruptions in many persons. Many jnen are seized with cuta- 
neous eruptions on changing their places of residence or drink- 
ing different water. Many kinds of water may indeed possess 
the faculty of rousing the latent disposition to cutaneous dis- 
eases. My observation leads me, however, to believe that 
those eruptions arise from discontinuing the usual water, which 
has the power of counterbalancing a certain innate tendency to 
eruptions on the skin. There are short-breathed horses which 
continue in good breath as long as they drink soft, flowing 
water. If transported to some other region, they become useless. 
Many men feel well as long as they drink a certain kind of 
mineral water, or take a certain kind of medicine, or smoke a 
certain kind of tobacco, or take snuff, for no other reason than 
this, that those substances counterbalance the habitual anormal 
dynamic relations existing in such individuals, and maintain a 
state of equilibrium which is necessary to the existence and 
continuance of a state of relative well-being. 

Section 30. 

The living organism is endowed with 

3. A tendency to reactions that are in polar ic opposition 
to the action of noxious agents. 

This tendency corresponds perfectly to the highest idea of 
life. This highest idea implies that the individual life should 
possess the power of offering a polaric resistance to the macro- 
cosmic influences, which threaten to destroy the individual. 
The idea of force throughout nature has an empiric founda- 
tion ; this however does not detract from its value. We should 
be ignorant of the force of gravitation and the centrifugal force, 
and of the principle of light, if we had not observed the mani- 
festations of those forces, and, if out of those observations, the 
idea of the forces had not been developed ; and yet we are 
proud of the consciousness of being able to construct solar 
and planetary systems by means of that idea. 


The tendency which is inherent in the living organism, to 
oppose the macrocosmic influences, is founded npon the gen- 
eral law that forces, after they are freed from all restraint, will 
become so much more active, as is shown by many things in in- 
organic nature ; for instance by the effects of elasticity, in con- 
sequence of which certain bodies are endowed with an endeavor 
to resume their original forms after they had been compressed by 
violent means,by expanding at first beyond the limits of their ori- 
ginal space, and gradually resuming their original dimensions. 
After rubbing a piece of glass, amber, sealing-wax or some other 
isolating electric body, those bodies attract small pieces of paper, 
and after a while repel them again with force. A similar phe- 
nomenon has been observed by Nobili, in the development of 
electricity by rotation. If a neutral wire be laid parallel to 
the voltaic circle, the electric current which is thus excited, has 
an opposite direction to the existing current. On removing 
the wire in the same position, its electric current becomes like 
that of the voltaic circle. Murray has observed that the mag- 
netic needle undergoes certain fixed deviations on being held 
near a flame, that it deviates in an opposite direction after the 
removal of the flame, and only gradually resumes its original 

The same law holds good in spiritual matters ; pressure 
calls out counter-pressure. The liberated prisoner is most in- 
clined to abuse his freedom, and many an artist owes his skill 
to the oppression which he had suffered in his youth. 

The hand which had been dipped in cold water, becomes 
cold, and remains cold as long as the water is cold enough to 
overcome the natural warmth of the hand. This is a positive 
primary effect of cold. On withdrawing the hand from the 
water, the warmth not only returns gradually to its former 
degree, but rises beyond it, so that the hand becomes burning- 
hot. The face becomes hot and red after returning from a 
w r alk in severe cold ; this, is a reaction of the organism which 
endeavors to overcome the effects of cold. 

After having got heated by dancing or by some other vio- 
lent exercise, and the fust effect has passed off, the skin be- 
comes cool, and one feels chilly. The same kind of chilliness 
is experienced after an intoxication. 

A cold or a cathartic occasions a diarrhoea, which is 
succeeded by constipation, with which those are especially 
affected who have taken a good deal of cathartic medicine. 

The primary effect of China is tonic, after that it has an 
expanding, relaxing effect, which is manifest by the bloated 
face, the swollen limbs and the distended spleen of those who 
have taken a good deal of that drug. 


Many people feel very ill while using the baths ; they be- 
come nervous and imagine they are afflicted with all sorts of 
ailments which they never had before. If the water corres- 
ponds to the morbid condition of the patients, they get fre- 
quently much better than they were before, after the primary 
effect of the baths has passed off. 

Shortly after a venesection the reproduction of the blood 
takes place very rapidly ; on this account congestions which 
have been removed once or twice by bleeding, are much more 
difficult to cure, than they would be in persons who have 
never been bled. For the same reason a suppression of the 
hemorrhoidal flux is attended with much more painful symp- 
toms than the mere haemorrhoidal pressing down, and females 
suffer much more from a suppression than young girls from a 
retention of the first catamenia. 

Starvation-cures emaciate one a good deal ; but persons 
who have gone through them incline to get very fat. The 
same fact is observed on patients who are recovering from an 
attack of fever with prostration of the reproductive powers ; 
children grow with astonishing rapidity after having gone 
through an acute disease with great emaciation. It has been 
a matter of surprise that many remedies should have evinced 
an action contrary to what they generally are supposed to 
possess. Some have contended for one, some for another ef- 
fect of a drug. Camphor, for instance, is by some supposed 
to possess cooling, by others heating qualities. It possesses 
either only at different periods. The first action of Cam- 
phor is rapidly cooling, followed shortly after by heat and 
sweat. Saltpetre acts similarly, but more slowly. The pri- 
mary effect of Digitalis is to increase the beats of the heart 
and to suppress the secretion of urine ; the secondary effect or 
the reaction of the organism induces collapse of pulse and 
copious secretion of urine. 

We know that the fust effect of spirituous drinks is to heat 
one and make one feel lively ; but after this effect has passed 
off, one feels languid and drowsy, on which account it is very 
dangerous to drink brandy while exposed to severe cold, 
whereas a little cold beer or water has an unpleasant effect at 
first, but afterwards occasions a pleasant feeling of increasing 
warmth from within outwards. Cold feet are most speedily 
got warm by dipping them in cold water or rubbing them with 
snow. Small doses of the primarily cooling camphor, or small 
doses of ice or cold water re-excited the animal heat of 
cholera-patients, even in cases where rigidity and death-like 
coldness had already set in. 

A little brandy, or a cup of coffee or tea occasions a 


pleasant feeling of coolness in those who have been very 
much heated. 

Men and animals who have become rigid from exposure 
to great cold, perish in a warm room, but recover again under 
a cover of snow. 

Section 31. 

The power of the living organism to oppose noxious influ- 
ences, is considered the vis medicatrix uaturce. The term 
reaction, by which that power is sometimes designated, is not 
sufficiently specific, inasmuch as the primary positive effect of 
the morbific agents likewise arises from a reaction of the or- 
ganism. The term " secondary effect " reminds us of the 
action of the drug rather than of that of the organism. Reac- 
tion and counter-effect have been until now comprised con- 
jointly under the collective appellation of reaction ; I shall take 
the liberty to distinguish the two. 

Reaction is an activity of the organism primarily excited 
by the influence of some external agent. 

Counteraction is synonymous with secondary action, and 
is contrary to the primary action. 

Hahnemann has designated- the secondary action by the 
term curative action. In the enanthiopathic method the pri- 
mary action is considered curative, though it is undoubtedly 
true that the secondary action is the most brilliant manifesta- 
tion of the power of the vital principle. 

Section 32. 
A crisis is a true vital process. 

As in the universe, so in the individual, the life-principle is 
subject to laws even in disease whose course and issue depend 
upon those laws. There is no such thing as a spontaneous 
effort of the disease to terminate critically. The termination 
of the disease depends upon the organism. 

1. Upon the condition of the vital forces, either generally 
or in single systems and tissues. A favorable crisis is a suc- 
cessful resistance of the organism to the disturbance which 
the hostile principle had occasioned. If the vital forces 
generally, or those of the affected organ in particular, be 
too weak, the counteraction which the organism requires to 
make in order to restore its equilibrium, is impossible. The 
morbid cause acquires a predominating influence, and the dis- 
ease becomes either chronic or else the organ is destroyed, and, 
if it be an organ indispensable to life, the individual perishes. 


The most common fatal terminations of pneumonia are paral- 
ysis or gangrene of the lungs. Paralysis arises from an en- 
tire exhaustion of the nervous life by violent reactions; in 
gangrene the exhaustion involves moreover the vegetative 
sphere. Single organs are sometimes affected sympathetically 
on account of an unequal distribution of the vital force, an ex- 
cess of conducting power in single nerves, or an excessive 
irritability ; such sympathetic sufferings are just as real as the 
primary affection. The organs which are affected sympatheti- 
cally may likewise go to destruction, and occasion the death of 
the individual. If the organs which are thus affected be of 
secondary importance, their affection assumes a vicarious 
character, and the organism is preserved by the sacrifice of 
one of its parts. In other cases sound organs react against 
affected ones ; this kind of reaction frequently results in a sup- 
pression of the morbid phenomena. In this way metastasis 
and metaschematismus take place, which are either favora- 
ble or unfavorable to the restoration of health. The most fa- 
vorable termination of the disease is the appearance of an 
opposite state in the primarily or secondarily affected organs, 
provided the vital forces remain otherwise unimpaired. Dry- 
ness of the skin is followed by .sweat, constipation by diarrhoea, 
dysuria by increased secretion of urine, raging delirium by 
rest and sleep. This transformation scarcely ever takes place 
in the whole organism at once, but in the same order in which 
the organs had been invaded by the disease, unless one organ 
should have been more intensely affected, and should, on that 
account, remain so much longer in a state of dynamic disturb- 
ance. Such an imperfect counteraction of the vital forces against 
the dynamic disturbance might be designated by the term "half- 
crisis" A fore-crisis (precursory crisis) is a state of dynamic 
oscillations arising from an equal struggling of the morbific 
agent and the vital force. Slow restorations of the equilibrium 
of the organism without any perceptible sign of oscillation, 
are termed " lyses." By "false crises " we mean the efforts 
of sympathetically suffering organs to restore their dynamic 
equilibrium, whilst the vitality of the more violently affected 
tissues is still too much depressed to accomplish a similar result. 
Secretory organs are frequently those that are first affected, 
or else they suffer sympathetically. If the secretions had 
been interrupted during the morbid state of the organ, they 
must be so much more copious when the normal functions of 
the organ are about to be restored. Formerly this increase of 
the secretions was considered the cause of the simultaneous 
return to health, whereas both are simultaneous consequences 


of the altered dynamic relations of the organism. It cannot be 
denied that injurious substances which had penetrated into the 
organism from without, or which had been formed in the organ- 
ism in consequence of a disturbed state of the reproductive func- 
tions, are frequently spontaneously excreted by the organism. 
This, however, is not always the case. In many cases recovery 
takes place without the secretions being altered or increased ; it 
is accompanied with phenomena denoting a disturbance of the 
nervous system, such as fainting fits, epileptic attacks, etc. 
The termination of a disease depends likewise 
2. Upon the nature of the affected organ, whether the affec- 
tion be primary or secondary. The more delicate organs are 
generally the more easily destroyed, and the diseases with 
which they are . affected, generally terminate the more 
speedily. Alterations of structure are of the utmost impor- 
tance. An inflammation of tuberculous lungs terminates most 
readily in suppuration, least frequently in gangrene ; an in- 
flammation of the cellular tissue generally terminates in 
dropsy, that of a muscle in dispersion or suppuration ; a stone 
in the bladder is never superinduced by St. Vitus' dance, but fre- 
quently by the gout, which is likewise rooted in secretory tissues. 
There are cases of disease which terminate in a manner 
that leaves it doubtful whether the recovery results from an 
endeavor of the organism to invert the polarity of its dynamic 
relations, for this reason, that no active reaction is apparently 
going on, and that we simply perceive a cessation of the for- 
mer anormal development. A violent inflammation, attended 
with great swelling, particularly orchitis, is sometimes followed 
by atrophy. This is not owing to an inherent endeavor of the 
organism to produce a state contrary to an excess of reproduc- 
tive activity, but the atrophy, in that case, results from the fact 
that the reproductive powers had been exhausted or paralyzed 
by the excessive irritation of a naturally irritable organ. 

Many dynamic disturbances terminate in a manner which 
seems to be a mere negation of the original condition. If 
pains or convulsions abate, the patient becomes quiet ; this 
quiet seems to be a sort of negative condition. Nevertheless 
there is opposition. The former dynamic relation, which oc- 
casions pain or convulsions, has been superseded by one that 
is opposite. Contraction is replaced by expansion, expansion 
by contraction. The opposition is therefore not limited to the 
mere external phenomena, but extends over the internal con- 
dition which is reflected by the external symptoms, and which 
the physician must take cognizance of, if he wishes to conduct 
the treatment intelligently. 


Section 33. 

The safety of the treatment depends upon a correct diagnosis. 

We will not deny the possibility of now and then perform- 
ing a successful cure without a correct diagnosis. Such a 
cure depends upon mere chance, which indeed sometimes es- 
tablishes the reputation of the most miserable quack. We 
cannot expect ever to penetrate the mysteries of nature, but we 
ought nevertheless to endeavor to know as much of disease 
as possible. 

Section 34. 

The object of diagnosis is to know disease. 

Disease is an internal vital process which manifests itself 
to our senses by symptoms. 

The particular kind of that anormal vital process is the 
nature of the disease, which ought not to be confounded with 
the proximate cause ; this is the inmost cause of the disease, 
hence the real object of cure. 

The nature of ascites is an effusion of serous fluid into the 
abdominal cavity. The proximate cause of this disease is 
either an increased secretion or diminished absorption. Kurt 
Sprengel observes very justly that the proximate cause de- 
termines the particular kind of the disease, and that the gen- 
eral nature of the disease constitutes the genus to which it 
belongs. Vomiting, as a general thing, consists in an antiper- 


istaltic motion of the stomach. The proximate cause of the 
vomiting may be an idiopathic irritation of the stomach by 
an emetic, by overloading it with food, by air excess of bile, 
inflammation, or by sympathetic irritation of the nerves of the 
stomach in consequence of concussion of the brain. The 
symptoms which indicate the nature of the disease, are too 
general to guide us in the selection of a remedy. Ascites is 
not cured by tapping. Vomiting may perhaps be suppressed 
for a time, but not cured, by so-called sedatives. If the vomit- 
ing is occasioned by the accumulation of noxious substances 
the danger is increased by sedatives. Help can only be af- 
forded by removing the cause. To discover the proximate 
cause of the disease, a vast amount of pathogenetic and physio- 
logical knowledge is required. The physician has to analyze the 
morbid process and to trace it to its commencement. Pathologists 
have distinguished the proximate, remote and remotest cause. 
In ascites diminished absorption may be the proximate cause ; 
the remote causes may be a pressure on venous trunks by a 
tumor, paralysis occasioned by an excessive irritation from 
abuse of China, or by spirituous drinks, or by a suppression of 
cutaneous eruptions, etc. He who is not acquainted with these 
remote causes, will not remove them, and will not be able to 
cure the disease. 

Section 35. 

The means of diagnosing disease are, 

(1.) Etiology, the doctrine of morbific causes. This doc- 
trine has arisen entirely from empiricism. As the develop- 
ment of the human mind progressed, attempts were made to 
establish a connection between the morbific causes and their 
eifects, and to invest the hitherto empirical doctrine of etiology 
with a scientific character. Our present science of pathogenesis 
is a sort of practical etiology, and is intimately connected with the 
doctrine termed " anamnesis," or the doctrine of the deleterious 
influences which exist previously to, and open a road for, the 
disease. Both those doctrines, etiology and anamnesis, are in- 
dispensable to the diagnostician, inasmuch as a correct diagno- 
sis is frequently impossible without a knowledge of the causes 
that* have occasioned it. For instance, there are cutaneous 
eruptions that cannot be distinguished from the real itch by the 
mere external appearance. There are genuine and spurious 
syphilitic ulcers that resemble each other in the highest degree, 
and the true nature of which can only be determined by the 
presence or absence of a previous infection. A child sudden- 


ly commences to limp ; but even after the most careful investi- 
gation we do not discover any symptoms of a constitutional 
disturbance. Upon being told that the child fell, and that a 
pain in the hip was experienced immediately after the fall, we 
obtain a more correct notion of the proximate cause of the 
child's affection than if we were merely told that the child had 
taken cold. Two individuals are in a state of coma. One 
had poisoned himself with opium, the other had a fall on his 
head. The latter would be killed by an emetic, which would 
save the life of the former. 

Physiological etiology teaches that there are two agents 
co-operating in the formation of disease ; an external, which is 
the morbific cause, and an internal agent, which is the organ- 
ism itself. The dynamic susceptibilities of the organism have 
to be carefully studied in order that the intensity of the disease 
should neither be over nor underrated. There are but few noxse 
which affect organisms of the same kind in the same manner. 
Of this number are miasms and poisons. These agents have 
been variously defined, but those definitions have been rejected. 
It is a characteristic property of those agents to occasion a de- 
finite disturbance of the organism, more or less independent of 
the modifying influences of the peculiar nature of the individ- 
ual. It is not very difficult to discover the action of poisonous 
substances in the organism. Etiological inquiries are valuable 
in another respect ; they frequently lead us to the discovery of 
some remote cause which keeps up the action of the proximate 
cause of the disease, and the removal of which is in many 
instances sufficient to a cure ; such remote causes are, for ex- 
ample, the presence of a quarrelsome person, a damp sleeping- 
apartment, a smoking stove, a hurtful favorite dish, a certain 
prejudicial occupation, etc. A painter cannot expect to remain 
free from colic as long as he continues to poison himself with 
lead by the introduction of the brush into his mouth ; nor will 
a worker in looking-glasses remain exempt from mercurial 
symptoms until he discontinues his business. 

Section 36. 

The morbific power of external agents, except miasmata 
and poisons, is altogether relative, and an unsafe basis for the 
ideal construction of a morbid condition. We are frequently 
unable to ascertain the cause why morbific agents act with 
such different degrees of intensity in different organisms. 
There is a certain disposition to some anormal condition in every 
individual, which is a preventive against other diseases. The 


susceptibility to disease is, in a great measure, modified by 
temperament and mind, advanced or retarded development of 
the moral sentiments and bodily strength, size, fleshiness or 
thinness, greater or lesser development of single organs, length 
of the neck, shape of the thorax, firmness or flaccidity of the 
muscles, age and sex, acuteness or dullness of the organs of 
sense, greater or lesser irritability of the general organism or 
of single organs. Even actual defects may sometimes serve 
to neutralize relatively hurtful influences, if the heart be lo- 
cated in the right side, a dagger plunged into the left will not 
reach it. Some time ago 1 read of a case of hydrocephalus 
which was accidentally cured by a nail being thrust into the 
anterior fontanelle of an infant. The opium-eater is pleasantly 
excited by a dose of opium which might destroy another 
man's life. If an organ be in a polaric condition opposite to 
that of health, its normal condition may be restored by an in- 
fluence which would subvert a state of normal polarity. In 
some cases, certain diseases may act as preventives against 
others. Syphilitic patients are seldom attacked by the orien- 
tal plague. Children who are affected with tinea are less fre- 
quently attacked by encephalitis ; open ulcers and suppurating 
herpes frequently protect one against acute contagious dis- 
eases. It is well known that habit and the mode of life are 
capable of increasing or diminishing the power of certain 
agents. A delicate nurse would perish in three days, if she were 
to be exposed during that period of time to the hot sun in a 
cornfield. The tailor would lose his health by working at the 
furnace, and the miner by crossing his legs on a tailor's 
board. What is injurious to one, may be useful to another. 
Not all men are similarly affected by the same hurtful influ- 
ences ; even if everybody had become sick inconsequence ofbe- 
ingexposed to those influences, yet it would not follow that the 
sickness must be the same in every case. Chagrin may occa- 
sion apoplexy as well as bilious fever ; a cold may induce a 
simple catarrh, ischias, or typhus. The value of etiology is 
extremely relative, although a knowledge of the causa occasi- 
onalis of the disease must be very useful to an observing phy- 
sician and one who is well versed in physiology. 

Section 37. 

A disease cannot be treated as long as it does not manifest 
itself by perceptible phenomena. The principal means of di- 
agno sis is, therefore, 


2. Symptomatology, or the doctrine of the symptoms. 
The lowest form of symptomatology may be termed nosogra- 
phy, a doctrine which teaches the mode of taking a correct 
record of the external perceptible symptoms of the disease. A 
higher form of symptomatology is the doctrine of the internal 
acceptation of the symptoms, semeiotic, which in conjunction 
with nosography, has elevated diagnosis to a higher rank. 
Our most estimable pathologists and therapeutists have com- 
plained of the imperfections of semeiotic. Girtanner com- 
plains of the darkness which surrounds us in the investigation 
of disease. Choulant says, that we know nothing of disease 
except the proximate cause and the totality of the symptoms. 
Most rejects the doctrines which we learn at the universities as 
trash which is useless to suffering humanity, and puffs up the 
learned fool like the toad in the fable. However, we can no 
more approve of the unqualified condemnation which Hahne- 
mann and Krueger-Hansen have pronounced on medicine, than 
we can be blind to the imperfections of semeiotic. The follow- 
ing are some of the reasons why it is difficult and frequently 
impossible to infer the nature of a disease from the mere 

1. In some cases the symptoms are either wanting or too in- 
distinct. Organs that are scantilyprovided with nerves, and are 
on that account rather insensible, such as theliver.may contain 
tubercles or even abscesses, or portions may be in a state of soft- 
ening, or may have been affected with other defects for years, 
without any external phenomena of disease. Even in nobler 
organs, the brain, heart and large vessels, disorganizations have 
been discovered which were not suspected by any body. Of 
this number are cases of sudden death from the bursting of the 
heart or the aorta at a place which had become thinner. Mor- 
gagni mentions a number of cases illustrative of the above re- 
marks. Sebastian made a post-mortem examination in the 
case of a man who had been sick with typhus abclominalis and 
had felt quite well for two years after, after the lapse of which 
period he died of acute pleurisy with purulent effusion into the 
cavity of the chest. The intestinal ulcers which are charac- 
teristic of typhus abdominalis, were found to exist yet in a state 
of integrity ; only two of them were distinctly cicatrized. Sev- 
eral years ago I found the whole right lung of a man trans- 
formed into a sac of pus. The man had never felt ill, had un- 
dergone many fatigues on horseback and foot, and had been 
hunting two days before his death without feeling in the least in- 
convenienced. He died with the symptoms of suffocative 
asthma within five days. It cannot be supposed that the purulent 


transformation should have taken place in that short space of 
time, so much more as inflammatory symptoms were entirely 

2. Many symptoms are deceitful, for this reason, that the 
phenomena by which sympathetic affections manifest them- 
selves, are frequently more distinct than the fundamental dis- 
turbance ; sometimes the more important disease is complicated 
with affections that are of less importance, but whose phenomena 
are more marked, and, on that account, engage our principal 
attention. Errors of diagnosis are frequently discovered only 
after death. De Haen discovered gangrene of the stomach in 
the body of a female who had been sick for only five days, 
during which time she took food, and drank barley-water, and 
had neither nausea, nor vomiting, nor any of the most essential 
inflammatory symptoms. According to Huguier, a woman 
was treated for two years in the hospital St. Louis for hypertro- 
phy of the heart; on making a post-mortem examination, the 
heart was found sound, but the lungs were studded with tuber- 
cles. Huguier likewise mentions a case of supposed tracheal 
phthisis, whereas the patient died of aneurism of the aorta. 
Fricke observes that, if the sensory be affected in tuberculous 
phthisis, the characteristic cough is frequently wanting. Bag- 
livi remarks that the most experienced men are frequently de- 
ceived by pulmonary diseases, even in spite of the stethescope. 
Philip]) of Berlin relates a case where auscultation pointed to a 
defect of the valves, dropsy of the pericardium and oedema of the 
lungs ; in the place of all this a post-mortem examination disclos- 
ed a partial thickening of the pericardium, dilatation of the left 
ventricle, and thickening of its walls, together with oedema of the 
lungs. Wynn of Glasgow discovered, in a man who died of 
dropsy, a complete degeneration of the kidneys, which could not 
be diagnosed by any external symptoms ; and Horst speaks of 
a case of complete destruction of both kidneys, where the urine 
continued to be emitted with perfect ease until the last days of 
the patient's life. De Haen found the spleen, subsequently to an 
inflammation of the lungs, transformed into a pappy substance, 
without any external phenomena pointing to the degeneration. 
He has frequently seen cases of enlargement of the liver extend- 
ing to the left hypochondrium, where other viscera were sup- 
posed to be affected. There are many morbid conditions, the 
characteristic symptoms of which are still very obscure. Of this 
number are tubercles in the brain, the affections of the pancreas. 
Some author lately spoke of an oedema of the spleen, of which 
nothing was known before. We know likewise very little of 
the asthma thymicum. It is particularly a matter of great un- 



certainty whether it is occasioned by hypertrophy of the 
thymus gland, as is maintained by Kopp and denied by Staub, 
who mentions a case of gastrobrosis where every symptom 
pointed to asthma thymicum. 

Section 38. 

As it would be unjust, on the one hand, to reproach a phy- 
sician with the impossibility of establishing a correct diagnosis 
when the means for so doing are wanting, so it would, on the 
other hand, be unpardonable to base a vigorous antipathic 
treatment upon a purely speculative view of disease. I will 
not here recapitulate the horrors which speculative theorists 
have made themselves guilty of. in the treatment of disease. 
The worst homoeopathist may be considered innocent in their 
presence. Two things may occur, if the realization of a wrong 
theory in practice should lead to bad results. Either the phy- 
sician is too vain to admit his error, and he continues to heap 
sin upon sin ; or else, aware of his mistake, he changes his 
view of the disease, and modifies the treatment accordingly. 
In this way he continues groping in the dark, and modifying 
his method of treatment from day to day. The pure effects of 
drugs, particularly those of the darling compounds, being very 
little known, the most prominent symptoms of the remedies 
that are used in a case, are frequently mistaken for new phe- 
nomena of the disease. This leads to new views about the 
character of the disease and to a change of treatment. Our 
journals are filled with reports of cases by the most celebrated 
physicians which betray the most woful vacillation between 
a pretended rational and symptomatic treatment. At times 
the disease is derived from infarctions of the intestines, at others 
from latent gout, at times again from a supposed rheumatic, 
herpetic, or some other acridity. There is much talk about la- 
tent haemorrhoids ; that is, haemorrhoids which are not any, and 
can only mean a congestive condition that may, under certain 
circumstances, occasion a haemorrhoidal flow, but may just as 
well cause a bleeding of the nose, a haemorrhage from the lungs 
or oesophagus, and might be termed latent bleeding of the nose, 
with the same propriety as it is termed latent piles. The 
doctrine of latent piles has been the hobby of the school of 
Stahl. For any irregularity of the circulation, a discharge 
from the haemorrhoidal veins was supposed to be the sovereign 
remedy. A man living abroad, who is affected with a chronic 
malady, sent me some time ago a large bundle of prescriptions, 
together with the opinons of five celebrated physicians, who 


had examined his case. All those physcians differed in opin- 
ion, for the simple reason that each took a different view of 
# the nature of the disease. All of them were mistaken. 

Section 39. 

According to Hahnemann we cannot know any thing of 
disease except the symptoms. The symptoms, in their totali- 
ty, reflect the internal disease ; that is, the affection of the vital 
force. A disease is cured as soon as the symptoms are, each 
of them, permanently removed. I shall examine this doctrine 
more particularly in the following paragraphs. 

Section 40. 

The symptoms are the external, objective manifestation of 
the morbid process which is taking place in the internal or- 

Every disease must necessarily manifest itself by a corre- 
sponding alteration of structure, sensations, or functions. 
Symptoms, however, are only one portion of the clue which 
leads to the perception of the true nature of the internal mor- 
bid process. 

In many cases of disease, the symptoms are so evident, 
that we are at once able to judge of the true nature of the dis- 
ease, and to determine the remedy. In some cases, however, 
the symptoms are not so clear, and the real nature of the dis- 
ease has to be determined by a process of a priori reasoning. 
By establishing his psora-doctrine, Hahnemann has admitted 
the necessity of speculative reasoning to determine the true na- 
ture of many forms of disease. 

Section 41. 

To form a correct diagnosis, we have to employ every 
available and requisite means. 

It is of especial importance 

1. To ascertain the influences by which the disease has 
been occasioned. Such an investigation can only be instituted 
by a well informed pathologist. A physician who is well 
versed in pathology will not inquire, in replacing a fractured 
bone, whether at some former period the patient has been affect- 
ed with syphilis ; but he will make such inquiries in a case of 
compound fracture, if the soft parts do not heal, if the wound 
discharge a badly colored ichor, and the edges of the wound 


assume a lardaceous appearance : all these symptoms point to 
some latent dyscrasia, the character of which he desires to 
know. If a child should be attacked with simple influenza, 
the physician will not find it necessary to inquire whether 
the child has been scrofulous. Such inquiries would be neces- 
sary if inflammation of the eyes should supervene, which does not 
yield to the ordinary remedies for catarrhal ophthalmia. Some- 
times children are attacked with swelling of the cervical glands 
in consequence of a cold; they feel like small peas, and are 
speedily reduced to their ordinary size by keeping the parts 
warm. If the physician should be informed, however, that 
the older sisters or brothers of the child have had scrofula, he 
would at once resort to the proper remedies to prevent the de- 
velopment of the scrofulous affection. The scientific physician 
will always endeavor to investigate every thing which may 
shed light on the case before him, hereditary disposition, tem- 
perament and constitution, idiosyncrasy, defects from badly 
directed education, effeminacy, injudicious attempts to harden 
the constitution, excessive efforts in studying, want of exercise, 
hard working at too early an age, bad or irritating nourishment, 
abuse of perfumes, excitement of the fancy in consequence of 
reading novels, onanism, violent suppression of excessive de- 
sires, excesses in venery, occupations favorable to the develop- 
ment of disease, irregular waking and sleeping, bad habits such 
as smoking, chewing, or taking snuff, unhealthy situation of 
one's house and particularly of one's sleeping apartments, want 
of cleanliness and fresh air, unhealthiness of the climate or lo- 
cality, hurtful mode of dressing, tight lacing, tight cravats or 
garters, too light or too heavy covering inducing either a defi- 
ciency or excess of perspiration. I am acquainted with a man 
who has coryza with perspiration as long as the corn is in blos- 
som, and who remains free from those complaints if he does 
not walk in the neighborhood of cornfields. Passions disturb 
the health in a definite but different maimer. We know that 
anger causes a rush of blood to the head, chagrin an increased 
secretion of bile, jealousy, grief, and care depress the reproductive 
and sensitive functions. In many cases it is of the utmost im- 
portance to inquire into the diseases with which the patient may 
have been affected previously. I content myself with mentioning 
suppressed hsemorrhages and dried-up ulcers. Syphilis and 
psora ought likewise to be alluded to. Schlegel has related a 
case of hemicrania of thirty years' standing, for which he pre- 
scribed corrosive sublimate, after ascertaining the syphilitic 
origin of the affection ; the disease was cured. Thirty years 
ago I cured a pharmaceutist of cardialgia by means of Guaja- 


cam, which I selected on account of the arthritic origin of the 
disease ; he had consulted many physicians, but in vain. At 
the same period I performed another cure which created some 
noise. A young girl was affected with jaundice, and had 
used for six weeks so-called dissolvent remedies, agreably to 
the prescriptions of some other physician. Being consulted, 
suggested that the disease might originate in a spasm of the 
liver, inasmuch as the patient had previously suffered with 
hysteric spasms, which had now ceased. I gave her Castoreum 
and she was well in eight days. Disturbances occasioned by 
the former abuse of medicine and by depletions require to be 
considered. We are fully acquainted with the destructive ef- 
fects of mercury upon the animal economy which often remain 
until death. The abuse of Iodine is likewise very dangerous. 
John has seen it cause nervous consumption. Dtirr has ob- 
served from frictions with the iodine-ointment for the removal 
of goitre, convulsions of the limbs and face, anguish, oppres- 
sive anxiety, palpitation of the heart, vomiting, violent head- 
ach, spasms and foam at the mouth. Vogel has seen a yel- 
lowish complexion turn suddenly blue in consequence of the 
use of Iodine. Busse mentions a case of slow poisoning by the 
flowers of zinc, of which a man of 43 years, affected with epi- 
lepsy, took 3246 grains within five months. He became an 
idiot and consumptive. Tangueral speaks of a case of fatal 
colic arising from the abuse of lead in hypertrophy of the heart, 
and of a cerebral affection in consequence of an accidental poi- 
soning with lead. I may mention the delapidated condition of 
the nervous system of the opium-eaters and of those who 
use the haschisch, a favorite drink prepared from hemp ; 
the leucophlegmasia and swelling of the spleen from the abuse 
of China ; the cachexia and blackness of the skin occasioned 
by the nitrate of silver : the scarlet eruption from the balsam 
of Copaiva ; the dyspepsia arising from the injudicious use of 
iron-water, and the bad effects from any improper use of min- 
eral waters generally. Krimer says : I am convinced that 
the abuse of mineral waters occasions the very ailments which 
the rational use of those waters would remove. The health 
of persons who keep a domestic pharmacy, and prescribe for 
themselves or their relatives a dose of medicine for every little 
trouble, is generally very poor. Some time ago the Frankfort im- 
perial pills were considered a panacea for every disease ; now 
the universal remedy is Morisson's pills, who has attempted to 
show in a special treatise that all diseases can be cured with 
purgatives. The abuse of worm-seed and Chamomile-tea 
^ives likewise rise to many disastrous results. Passionate 


drinkers of chamomile-tea are frequently affected with bilious 
troubles, vexed mood, and morbid irritability of the peripheral 
nerves, with a disposition to inflammatory cutaneous affections. 
Lyina-in women frequently have rash and sore nipples from 
the abuse of chamomile. The infants suffer still more, partic- 
ularly if they too take the chamomile. Winter considers the 
abuse of chamomile one of the causes of gastromalacia. The 
most ordinary consequences of an inordinate use of chamomile 
are green stools, colic, flatulence, restlessness, tendency to start, 
rash, soreness under the arms, and in the neighboorhod of 
the sexual organs. These consequences are not seen in lying- 
in hospitals where chamomile-tea is the usual beverage ot the 
mothers : they make their appearance after the patients leave 
the institution. Other physicians might see those facts just as 
well as one of our school; but in their estimation every thing 
emanating from Hahnemann is deemed unworthy of any se- 
sious consideration. 

It is of great importance to ascertain whether influences 
which have occasioned a disposition for certain diseases, do 
still exist, or whether all that remains of them, is their after- 

Section 42. 

It is likewise of great importance to observe, 
2. The ruling character or disposition of disease, designated 
in the German books by " genius of disease." We know from 
experience, that the general character of disease is modified by 
various sideral, telluric and meteorological influences. This 
is particularly the case with epidemic, and sometimes also 
with sporadic diseases. If we know that the character of a 
prevalent disease is inflammatory, or rheumatic, gastric, bilious, 
typhoid, or putrid, this character will appear more or less in 
every single case. This would not do away with the necessi- 
ty of studying every case, and prescribing in accordance with 
the perceptible phenomena of the disease. 

Section 43. 

We derive some of the best means of diagnosis from 
3. The history of the case. In every case which is not en- 
tirely clear, we have to inquire into the first symptoms of the 
disease, of the patient himself, or of those who had an opportu- 
nity of watching him. Sometimes it seems at first as if we 


could not learn any thing about the case ; however, every 
new question leads to a new answer, and we finally succeed 
in obtaining the desired information. I have frequently observed 
that those of whom we expected the least information, can 
furnish us most. The servant is not apt to overlook the ill- 
humor with which his master may be tormented previous to 
an illness. The barber notices the bad smell from the mouth, 
and the cook, on hearing frequent complaints about the insi- 
pidity of the food, is easily led to suppose that her mistress's ap- 
petite is deranged. It is highly instructive to investigate the suc- 
cessive appearance of all the symptoms of a disease ; this kind 
of inquiry makes us acquainted with the starting point of the 
disease, and with the manner in which the morbid process has 
developed itself in the organism. It is frequently a difficult busi- 
ness to trace a disease to its cause, or to connect all the symptoms 
into one series of effects. Wherever the series seems to be in- 
terrupted, we have to supply the omission, by studying the 
physiological relation of the symptoms. We know that a de- 
ficiency of nervous power may prevent the manifestation of 
symptoms in some parts of the organism, and that other parts are 
more intensely affected on account of the acute sensitiveness 
with which they are endowed. 

Section 44. 

We ought not to neglect 

4. The old rule, to notice the influences which are injurious 
or advantageous to the patient. 

In inquiring into the precursory symptoms, it is advisable 
that we should inform ourselves of the external influences 
which aggravate or ameliorate the condition of the patient. 
If we have reason to suspect that the disease is of an inflam- 
matory nature, our suspicion will be confirmed if we are told 
that stimulating influences aggravate, and cool air, cooling 
nourishments and drinks ameliorate the condition of the pa- 
tient. If the symptoms should be very uncertain, and we should 
be told that wine is of decided benefit to the patient, we would 
then conclude that the disease has an adynamic character. 
The useful or hurtful action of certain remedies, from profes- 
sional or domestic practice, may likewise throw light on the 
nature of the disease. Without going into details, let|me state, 
by way of example, that a herpetic clyscrasia manifests itself 
by the little vesicles starting up around the red surface induc- 
ed by a vesicatory ; that the sudden prostration of strength 


after venesection betrays a real debility of the vital forces ; 
that our suspicions of the syphilitic nature of an ulcer are jus- 
tified by the fact of the ulcer healing under the action of mer- 
cury ; that our suspicion of an organic defect increases to a 
certainty, if remedies of a positively different nature do not 
seem to affect the case in the least. Here, too, mistakes may 
occur, particularly with physicians, whose powers of logic and 
observation are deficient. 

Section 45. 

An indispensable condition of a correct diagnosis is, 

5. Appreciation of the existing symptoms. 

Hahnemann asserts that the examination of a case requires 
nothing but impartiality, sound sense, close observation, and 
a faithful record of the symptoms. I think that this is not 
sufficient. We ought not only to know the symptoms indi- 
vidually, but in their true relation. To study the true scientific 
connection of the symptoms, we have to institute 

A correct examination of the patient. 

Such an examination can only be instituted by a physician 
well acquainted with physiology, pathology, and pathogenesis, 
provided he is otherwise endowed with sound sense, and 
sufficient powers of observation. The manner in which a 
physician conducts the examination of a case, is the best touch- 
stone of his natural capabilities as a physician. So much is 
said of practical tact. The true practical tact consists in the 
talent of obtaining, at the first glance, a correct idea of the pa- 
tient's illness. Practice may develope that talent ; but, it can 
never be acquired by mere study. There are many men who 
are unable to improve the teachings of experience. There is 
an immense difference between erudition and practical wisdom, 
and the most learned physicians, are frequently very bad prac- 

There are many diseases that are at once known by their 
symptoms. Anasarca cannot well be confounded with an- 
other disease ; nor can hydrothorax, to which the oedema of 
the eyelids, the keeping the mouth open, the dropping of the 
blue lower lip, and the difficult breathing, with the shoulders 
drawn forward, point sufficiently to induce us to direct our ques- 
tions with reference to that disease. Good observers are capable 
of discovering the nature of the case, even when the symptoms 


are not well marked. This talent is particularly valuable in 
treating sick children. A description of the general features of 
the disease, either by the patient or by those around him, is fre- 
quently sufficient to lead the careful observer to such questions 
as have a direct bearing upon the case. If possible, the patient 
ought to be seen and examined by the physician personally. 
I have frequently found that the report which had been sent 
to me of a case, gave me an idea entirely different from the 
real state of things. It is frequently stated in such reports that 
the patient has fine red cheeks, whereas the cheeks are suf- 
fused with the hectic flush. If country-people complain of 
pains in the chest, it is generally cardialgia, and by pains in the 
stomach, the most varied sensations are frequently designated. 
It is well to know the character and temperament of the 
patient, lest we should either over or under-rate the value of 
his subjective symptoms. Anxious and sensitive persons are 
apt to describe their sufferings in the strongest language. 
Hysteric novel-readers talk about spasms, when they have 
only cold feet. Torpid and phlegmatic patients fail in the 
other extreme, and frequently do not even take the trouble of in- 
forming their physician of serious indispositions. 

Section 46. 

Hahnemann directs that the symptoms of a case should be 
recorded in the words of the patient. This proceeding is par- 
ticularly advantageous to a physician who is unable to select 
a remedy except by comparing the symptoms of the case with 
those of the remedy. I do not comply with Hahnemann's di- 
rections in this respect, in the first place because I like to avoid 
the appearance of an affected conscientiousness, and in the 
second place because I do not think it necessary that the case 
should be recorded in the manner prescribed. In a complicat- 
ed and doubtful case it is of great use to note every thing 
concerning the disposition of the patient for the disease, the de- 
velopment and characteristic features of the disease, and to 
base one's opinion about the case upon a careful study and 
combination of the details of the record. 

Section 47. 

In examining a patient, it is not advisable to commence at 
the head and end at the feet, which is the order of the symp- 
toms in Hahnemann's Materia Medica. 

The proper method is to let the patient state his case as he 


recollects it, in the order in which the symptoms have devel- 
oped themselves. This will give the physician a general idea 
of the character of the disease and of the organs which are 
more particularly affected, and will enable him to give his 
questions a more definite shape and direction. 

The physician seldom succeeds in obtaining a correct idea 
of his patient's illness after one examination. At the first visit 
of the physician the patient is generally somewhat excited ; 
he does not show his real condition until he has become 
somewhat accustomed to the doctor. 

No one has paid more attention to symptoms than Hahne- 
mann. It is undoubtedly true that the symptoms of a disease, 
in all doubtful cases, at least, are a safer guide than speculative 
reasoning. Under the term " symptoms" I comprehend every 
thing which indicates a deviation from the former healthy 

Section 48. 
We have to consider 
1. The conditon of the sensitive sphere. 

This sphere comprises the phenomena of the mind and 
disposition, including imagination, judgment, feeling, tempera- 
ment. Many diseases are characterized by an increase or de- 
crease of certain faculties, by an inability to form correct 
ideas of things which may give rise to delirium. In such a 
case we have to inquire whether the delirium proceeds from 
mental derangement or from an illusion of the senses. 

In other diseases the affective sphere is particularly invad- 
ed. The patient is either more cheerful or more gloomy than 
usual, he is more sensitive, disposed to anger, chagrin, distrust, 
jealousy, malice, or he is more indifferent, even to those things 
or persons that are dearest to him. Of particular importance 
are : a complete change in the disposition and desires of the 
patient, excessive anxiety, desire to die, suppression or increas- 
ed excitement of the sexual instinct, satyriasis, nymphoma- 
nia, etc. 

Under this head belong the functions of the senses, increase 
or diminution of the visual power, illusions of sight. I have 
known a hysteric girl who fell into convulsions at the sight of 
a bright-red color. We have to notice an increase or decrease 
of hearing, and the various kinds of noise perceived by the 
patient, such as whizzing, humming, roaring, ringing, etc. 


Changes occurring in the other senses have likewise to be no- 

Dreams should not be omitted. Coherent dreems about his- 
torical events are generally experienced only by persons in per- 
fect health. It is well known that we are apt to dream of dead 
men when rainy weather threatens to set in; this indicates, in- 
deed,that the state of the weather has an influence on the mind, 
but does not admit of any further explanation. Jean Paul ob- 
serves that we are more inclined to fly than to walk in our 
dreams. This is quite natural, as the imagination is particu- 
larly active in dreams, and it is much more natural and plea- 
sant for the imagination to fly than to walk. Anxious dreams 
are generally induced by a deranged digestion or irregular 
circulation. Dreams filling the soul with bliss at the termina- 
tion of a severe illness, are frequently precursors of approach- 
ing death, and the transfigured expression of the countenance 
indicates a desire on the part of the soul to enjoy higher 

We must not omit to consider the increase or decrease of 
the sensibility of the organism in general as well as of single 
tissues and organs, and have to observe with particular atten- 
tion the relation of the cerebral and ganglionic systems of 
nerves. The physician should study the physiological rela- 
tion of the symptoms, in order to understand them correctly. 

The subjective symptoms deserve particular attention. Un- 
der this head belong the various kinds of pain, the easy or dif- 
cult performance of certain motions and works, general weari- 
ness, or weariness of certain parts, heaviness, numbness and 
going to sleep of the limbs, titillation and itching, disposition to 
stretch, etc. In regard to the pains, we have to investigate the 
seat, violence, duration, and peculiar nature of the pains, whether 
they are stinging, burning, aching, gnawing, corrosive, boring, 
tearing, drawing, throbbing, cutting, etc, The temperature of 
the body, or the feeling of heat or coldness, which is often in 
direct opposition to the temperature of the atmosphere, requires 
to be noticed. In the case of insane persons and infants, the 
symptoms can only be studied from the features and gestures 
of the patient. If the patient experience pains in the chest, 
the breathing is short and deep, inspirations are painful. In 
violent paroxysms of cardialgia, the trunk is generally bent for- 
ward, and the drawing up of the knees, and the stamping with 
the feet, generally betray colicky pains. If children suffer with 
pains in the ears, they generally cry constantly, and with a never 
varying degree of violence. Headach is frequently discovered 
by an increase of heat and sweat about the head, and by the 


fact that the little patient frequently grasps at his head. Cata- 
lepsy, fainting turns, spasms, and convulsions, (although mus- 
cular motions take place in the latter), are nervous affections, 
together with many others which cannot all be enumerated 

Section 49. 

2. The symptoms of the irritable sphere are likewise of 
great importance. 

The heart, which is the central organ of the irritable sys- 
tem, appeals more particularly to the attention of the physician. 
The pulse and the beats of the heart tell us whether the func- 
tions of the heart are normal or anormal. This is not the 
place for a doctrine of the pulse. Physicians of every school 
should be familiar with it. The doctrine of the pulse has been 
cultivated by some with a ridiculous care. The Chinese 
speak of a " stomach," " bowel," " liver," and " kidney-pulse, " by 
which they pretend to ascertain the diseases of those organs. 
The Spaniard Francis Solano de Lugue, speaks of a he- 
morrhoidal pulse, of which Sauvage likewise makes mention. 
Borden has indicated the rhythm of the different kinds of pnlse 
by means of musical notes, which is not an improper mode 
of designation. Wetsch has furnished a good compilation of 
all that has been said on the pulse. Delias calls the inter- 
mittent pulse accompanied with abdominal irregularities, bow- 
el-pulse. This is an incorrect designation, since the inter- 
mission of the pulse likewise occurs in diseases of the heart, and 
in pneumonia. Argentier himself suffered for some time with 
intermittent pulse, in consequence of excessive study, and is 
said to have been cured by a bleeding. Prosper Alpin speaks 
of this pulse as the precursor of some crisis by the urine. 
Physicians novv-a-days are less prone to such subtle specula- 
tions, although in many cases the condition of the pulse is 
considered more important than it really is. Later observa- 
tions have shown what great influence the time of the day or 
night, motion or rest, and the position of the body have upon 
the pulse. In typhus, the pulse frequently does not reveal any 
thing ; hence the old remark in typhus : " Pulsus bonus, urina 
bona et ager moritur." Irregularities are so natural to many 
men, that they constitute a part of their well-being. I have 
known persons in whom the usually intermitting pulse became 
regular when they were sick. Such peculiarities may easily 
misguide a physician, unless he was acquainted with them 
previously. Repeated attacks of venous pulsation could not 
well be overlooked, and would lead one to suppose that certain 


properties of the arterial system have been transmitted to the 
venous circulation. 

The ; diagnosis of the diseases of the heart has been facili- 
tated a good deal by the still imperfect doctrine of auscultation, 
although there are cases where auscultation leaves us in the 
lurch. Physicians without natural aptitude for that art, will 
never become skilful auscultators. 

The general condition of the irritable sphere is not only 
determined by the rhythm and force of the beats of the heart 
and pulse, but also by the energy with which the reactions of 
the irritable system generally, or of some parts in particular, 
take place. No attentive observer will fail in noticing the al- 
terations occurring in that system. 

Section 50. 

3. The anormal symptoms of the reproductive system 
deserve the same attention. 

Under this head belong, 

(a) The symptoms of the digestive functions, canine hun- 
ger and excessive thirst, or decrease of appetite and thirst ; de- 
sire for or aversion to particular things, coated tongue, altera- 
tion of taste, eructations, bitter, sour, sweet, putrid, greasy or 
rancid, hiccough, regurgitation of food, nausea, retching, and 
vomiting, having regard to the substances which are thrown 
up ; feeling of emptiness or fullness in the stomach, retraction or 
bloatedness of the epigastrium or hypogastrium or of the hy- 
pochondria, hardness, elasticity, fluctuation, or softness of the 
distended abdomen ; anormal alvine evacuations, constipation, 
costiveness or diarrhoea, with discharge of the most varied sub- 
stances which require to be examined with care ; relaxation 
or spasmodic stricture of the rectum, tenesmus, etc. 

The nature of the urine and the mode of emitting it, ought 
not to be overlooked. The emission may be involuntary, im- 
peded, or entirely arrested. In acute diseases, a copious watery 
urine shows that the disease is not of an inflammatory na- 
ture ; from a scanty, dark, and hot urine, an inflammatory cha- 
racter may be inferred ; and a dark urine which tinges the 
linen yellow would induce a belief, even if we did not seethe 
patient, that he is suffering with jaundice. In diseases of the 
urinary organs a careful examination of the urine is a matter 
of course. 

b. The symptoms of disturbed respiration, both of the lungs 
and skin, difficult, deep, slow, anxious, short, and hurried 
breathing, or breathing which is only possible in certain posi- 


tions of the body, observing moreover whether the inspirations 
or expirations are more difficult, whether the breathing is car- 
ried on with a certain regularity, whether the breath is fetid, 
whether the fetid odor from the mouth proceeds from the 
teeth, or from a deranged stomach, whether the breathing is 
attended with a particular noise, etc. The different kinds of 
cough, require likewise to be inquired into with great care. 
The symptoms of an anormal cutaneous action are likewise 
of great importance; these are, for instance, increase or de- 
crease of the exhalation from the skin, dryness or moisture of 
the skin, alteration of the general or partial sweat, whether 
it is cold or warm, watery or greasy, oily, bloody, sour, pungent 
and biting, musty or putrid, including the kind of stain which 
the sweat leaves on the linen. The symptoms of the repro- 
ductive system include likewise, 

(c) The symptoms of an anormal metamorphosis generally, 
which takes place principally in the whole capillary system. 
Such symptoms are, general or partial hypertrophy, obesity 
or emaciation, brittleness or softening of bones, rigidity or re- 
laxation of the soft parts, changes of the hair, falling out or ex- 
cessive growth, dryness or greasiness of the hair, rapid and pre- 
mature whitening of the hair, etc. I ought not to omit speaking of 
the process of sanguification, a subject which has been discussed 
with much bitterness by the opponeuts and adherents of homoeo- 
pathy. Hahnemann's assertion, that no one has ever had a drop 
of blood too much, has surprised the medical world the more as 
it was uttered at a period when scarcely any physician would 
admit that diseases attended with great vascular action, or dis- 
eases of an inflammatory nature, could be controlled otherwise 
than by depleting means. Chrysijjpos of Knidos, Erasistra- 
tus, Baptist van Helmont, Cornelius van Bo?itekoe, and a 
number of ancient and modern authors, have maintained the 
same doctrine. Without reviewing the reasons which have 
been given for or against the propriety of abstracting blood, 
I shall confine myself to an examination of the question. Can 
the process of sanguification be carried on to excess? 

No unprejudiced observer will deny that any vital function 
may exceed its proper limits ; that sensibility, irritability, and 
the reproductive functions may be excessive. If this were 
not so, no disease could ever exist. Hypertrophies have been 
observed in every part of the organism. There may be ex- 
cessive secretions of mucus, gastric juice, bile, semen, ceru- 
men, sweat, urine, serum; why not of blood? There is no 
physiological reason why the blood should be an exception. 
We know from experience that some men have an abundance 


of blood, and that in others there seems to be a scarcity of that 
fluid. This condition of the organism is frequently the result 
of a congenital disposition. There are whole families in whom 
a plethoric disposition is hereditary. There are families in 
whose members the least wound occasions a dangerous hae- 
morrhage, although it is doubtful whether this is owing to an 
excessive sanguification. Plethora, even where there is no 
marked constitutional disposition, may result from a rich diet, 
if the digestive functions be otherwise good and a person take 
too little exercise, or from the use of beer, from too long sleeping ; 
it may be likewise occasioned hy repeated depletions, by 
means of which the volume of blood is indeed diminished at 
first, but a new tendency excited in the organism to reproduce 
the wasted fluid. 

Symptoms of plethora are : Glistening of the eyes, frequent 
obscurations of sight with vertigo, particularly on stooping, 
and when getting heated by some cause or other ; feeling of 
fullness in the chest ; difficult breathing ; slow, full beating of 
the heart and arteries ; increased temperature in the whole bo- 
dy ; feeling of heaviness and indolence ; frequent going to 
sleep of the limbs ; snoring during sbep. with hard breathing 
and anxious dreams ; frequent dropping of blood from the nose ; 
great relief from the above mentioned complaints by bleeding, or 
by meagre diet, drinking water, lemonade, and other cooling 
drinks. In true plethora, the above symptoms are almost con- 
stantly present ; their occasional presence, or their sudden recur- 
rence after a long intermission, only denotes a temporary irrita- 
tion or congestion, which may come and go suddenly. Plethora 
iomes on gradually and is more permanent. It is of the utmost 
mportance in practice to distinguish plethora from temporary 
congestion, inasmuch as the propriety or impropriety of bleeding 
depends in a great measure upon that distinction. I shall recur to 
this subject hereafter. 

It has alreadybeen stated that the other fluids of the organism 
may be secreted in excess. This is easily seen, particularly 
when the substances are excreted from the organism. The 
symptoms of an excessive or deficient secretion of bile require 
a somewhat closer examination. It is a matter of course that 
the alterations in the quality of the secretions should be care- 
fully noticed. 

Section 51. , 

There are many morbid symptoms which do not seem to be- 
long to either of the three spheres of vitality exclusively, and 


seem to denote a general disturbance of the vital forces col- 

Among these symptoms we class an increase or decrease 
of animal heat, either in the whole or part of the organism ; 
changes of features ; alteration of the lustre and turgor of the 
eyes, of the color of the face, lips, tongue, palate, and gums ; 
nature of the different coatings of the tongue ; moist or parch- 
ed appearance and rhagades of the tongue ; alterations of the 
voice, faculty of swallowing, sexual functions ; morbid charac- 
ter, first appearance and cessation of the menses ; and finally 
all the morbid phenomena relating to pregnancy, confinement, 
and lactation. It is scarcely necessary to mention the different 
hemorrhoidal affections. In cutaneous eruptions, their shape, 
and the changes through which they run at different periods, 
together with the accompanying general or local phenomena, 
such as itching, burning, etc., have to be examined with great 
care. This rule applies likewise to excoriations, vesicles, tu- 
bercles, aphthae and scurfs in the mouth and nose, ears, on and 
in the genital organs, rectum, etc. Children have to be ex- 
amined repeatedly, and with one's own eyes, in order that 
their ailments may be correctly ascertained. We ought not 
to overlook dentition, although it is my belief that its pathogen- 
etic influence is generally overrated. The phenomena at the 
period of pubescence, and the influence of age and sex general- 
ly, should be carefully considered. 

The aggravations or ameliorations which take place in the 
condition of the patient, deserve a particular consideration. 
They occur at a particular hour of the day, or at a time when 
the stomach is empty, during and after eating or drinking, 
during motion or rest, warmth or cold, in the open air or in the 
room, in damp or dry weather, in or out of bed, when sitting, 
standing, walking, lying, riding on horseback, or in a carriage. 
The manner in which certain symptoms succeed one another, 
or alternate with one another, the type of a fever, the appearance 
of some symptoms while others disappear, for instance the 
alternate occurrence of gout and haemorrhoidal complaints, 
diarrhoea and megrim, have to be carefully inquired into. If 
symptoms of different diseases exist simultaneously, it is neces- 
sary to ascertain which have existed first, for instance in head- 
ache and nausea, which may depend each upon the other. 

Section 52. 

It has been deemed of importance, and justly so, to dis- 
tinguish essential from non-essential symptoms. This is not 
always an easy business. 


By essential symptoms we mean those that belong more 
or less to all the diseases of one class, and characterize a mor- 
bid process which, no matter in what individual it may take 
place, manifests itself in a great measure by similar symptoms. 
Such symptoms are therefore also termed pathognomonic. 

Non-essential symptoms may depend upon various causes. 
They may depend upon a disposition to sympathetic affections, 
which may be different in different individuals, and, according 
as it is either present or absent, determines the presence or ab- 
sence of those affections ; or those non-essential symptoms may 
depend upon some incidental complication, developing them- 
selves as a totally distinct affection which, in its turn, is an es- 
sential morbid state in reference to its own particular ex- 
citing cause. If one be at the same time affected with itch 
and intermittent fever, the essential symptoms of the former 
are the eruption and the itching, and those of the latter, the 
symptoms occurring during the paroxysms. Incidental symp- 
toms only claim a moderate degree of attention ; I prefer calling 
them accidental. Sympathetic affections are not accidental, ex- 
cept with reference to the class under which they are arranged 
in nosological systems, but not in regard to the individual 
whom we are called upon to treat, inasmuch as in the treat- 
ment of no matter what case of disease, every symptom is 
a therapeutic indication, and, as such, deserving of considera- 

There is no perfect certainty any where, except in pure 
mathematics. The physician is bound, however, to obtain as 
much certainty as he can in his art. A superficial observer 
will always remain a blunderer ; nor will the fool who has no 
other claim to his diploma than the knowledge which he com- 
mits to memory, rise above mediocrity. 

Section 53. 

The highest object of therapeutics is to remove every 
symptom of the disease. 

When the art of healing was yet in its cradle, all the efforts 
of the physician were directed to remove the most prominent 
symptoms. These constituting in many cases the essential 
character of the disease, such a method of treatment must have 
very frequently led to a perfect cure. A number of remedies 
which have been thus empirically used for headache, tooth- 
ache, vomiting, uterine diseases, etc., have been handed down 
to us, and are now used in domestic practice. For a long 
time past, however, it has been felt that the removal of single 


symptoms does not constitute a cure, any more than we can ex- 
tinguish the flames of a burning house by directing the stream 
against one side only. The fruitless attempts to combat the 
totality of the symptoms by a combination of remedies produc- 
ing opposite effects, finally led to the conviction that every dis- 
ease, in order to be cured, must be seized by the root, hi this 
way the idea of rational medicine has first been started, and 
will ultimately triumph, in spite of the sneers and arguments 
of its opponents. 

Section 54. 

The science of therapeutics is based upon a knowledge 
of the object of cure, and of the remedial agents. 

The necessity of studying the object of cure, has been 
dwelt upon with sufficient length in the chapters on diagnosis. 
We therefore pass at once to a consideration of the Materia 
Medica, under which name we comprehend every thing which 
we require to know for the cure of disease. The Materia Medica 
is divided into the following branches : pharmacognosy, or the 
doctrine of the physical properties, and the external character- 
istics of drugs ; pharmacy, or the doctrine of the preparation 
and combination of drugs ; and pharmacodynamics, or the 
doctrine of the effects of drugs upon the living organism. In 
a therapeutic point of view the last branch is undoubtedly the 
most important. 

Section 55. 

To combat forces by forces, we must in the first place 
know what they are. In endeavoring to establish a rational 
system of medicine, its authors were not content with ascer- 
taining the phenomena which generally make their appearance 
after the administration of one or the other drug ; they wished 
to know the laws which govern those phenomena. An inves- 
tigation of those laws has not only given us a deeper insight 
into the mechanism of the vital forces, but has likewise led us to 
consider the relation which the forces of the organism and the 
opposing physical agents hold to one another. Our attempts 
in this respect have only been partially successful. In spite 
of our endeavors to infer the dynamic relation of drugs to the 
living organism from their physical properties, their shape, 
chemical composition, polarity, electro-galvanic or magnetic 
nature, we have not succeeded in establishing the science of 
pharmacodynamics upon a priori principles. This science, 


however, ought to be something more than a mere juxtaposi- 
tion of facts which have been committed to memory. It be- 
hoves us to examine the nature of the effects which the drug 
produces upon the general organism, or upon single organs and 
tissues, to combine those effects into a physiological unit by 
tracing their material or sympathetic connection from organ 
to organ, and, in this way, to invest the empirically dis- 
covered facts with the dignity of science. Hence it is that we 
do not content ourselves with establishing a general classifica- 
tion of drugs, but we endeavor to point out the organs which 
are specifically affected by the drugs, and the manner in which 
the drug acts. An increase or decrease of the pulse shows 
that the irritability is either increased or depressed. The idea 
of contraction or expansion has been inferred from a dimin- 
ished or increased secretion of serum or mucus, from an arrest 
or increase of haemorrhage, from a contraction or dilatation of 
the vessels. The reaction of organs that secrete fluids, is dis- 
tinguished into alkaline and acid. We have remedies which 
correct the secretions and the composition of the tissues, remedies 
which excite or restrain the reproductive process, and remedies 
that increase or diminish the sensibility, and are therefore able 
both to remove and produce nervous irritation or torpor. Ex- 
periments have been made to determine the difference in the 
action of larger or smaller doses of a drug upon an organ, and 
the peculiar train of symptoms which is set up in one or the 
other organ, according as a drug is administered in large or 
small doses. 

Many drugs act at first upon a certain tissue in such a strik- 
ing manner, and thence extend their action over the whole 
organism in such a steady progression, that it is pretty easy 
to describe their permanent physiological effects with a good 
deal of accuracy, and to point out the alternate exaltation and 
depression which drugs occasion in the organic spheres in po- 
laric opposition to one another. In many cases it is extremely 
difficult to indicate the dynamic condition reflected by the ex- 
ternal phenomena. The desire to account for those phenome- 
na, has frequently led to the most fanciful theories. I am far 
from desiring to lessen the merit of other authors, and therefore 
refrain from quoting examples. Any one may convince him- 
self of the correctness of my remark by looking even at our 
best classifications of remedial agents, where the most heteroge- 
neous substances, such as Moschus and Carbo vegetabilis, are 
found side by side. 


Section 56. 

The incompleteness of our knowledge of the effects of 
drugs is owing : 

1. To the difference of views about the physiological action 
of drugs generally. 

For a long time, it was supposed that drugs acted mechan- 
ically, hence the notions of diluting, inspissating, dissolving, 
boiling, filtering, of a falling back or pushing forward of the 
humors, etc., the existence of a vital power being entirely 
overlooked. For the last twenty years the mechanical notions 
have been, it is true, abandoned ; nevertheless they have made 
an impression on the mind, which, like a nursery-tale, clings 
to us in spite of our better convictions. 

The chemical doctrines even, have not yet been abandoned, 
although chemical agents destroy the vital functions, and every 
chemical product in the organism is entirely destitute of 
vital action. 

What has been said of chemico-vital action has no sense, 
except in so far as we understand by that action the simul- 
taneous presence of vital and chemical laws in the organism ; 
this, however, is not intelligible, as those two orders of laws are 
opposed to one another, and the preservation of life depends 
upon an absolute control of chemical action. 

The attempt to account for the effects of drugs by stoechio- 
metric principles, has been still more unfortunate. Such prin- 
ciples apply to dead substances only. We have already shown 
that it is impossible to represent life as an electro-galvanic pro- 
cess, and to account for the re-actions of the organism upon 
such grounds. 

All those modes of explaining the vital process having been 
found imperfect, we have been induced to designate the power 
of drugs by the term dynamic, basing that power upon the 
presence of some occult self-existing force. We know this 
force by its phenomena only, which show that all the other 
forces which seem to be active in the organism, are subordinate 
to that highest power. The vital process is neither mechanical, 
nor chemical, nor stcechiometric, nor electro-galvanic, but is a 
higher power which avails itself of these subordinate principles 
in the performance of its functions. The idea of the dynamic 
action of drugs is therefore more comprehensive than any 
other, inasmuch as every sensation and function can be ration- 
ally accounted for upon such a ground. 


The deficiency of our knowledge of the effects of drugs is 

2. To the impossibility of accounting for every phenomenon 
in the present imperfect state of our knowledge. Who can 
satisfactorily account for the fact that diabetes and cataract, 
pulmonary phthisis and fistula of the rectum, co-exist so fre- 
quently in one and the same individual ? or why Belladonna, 
which acts primarily upon the sensitive sphere, or turpentine 
and the balsam of copaiva, which effect primarily the uro- 
poetic system, occasion at the same time an inflammatory red- 
ness of the skin? Our provings upon the healthy furnish a 
number of symptoms, the physiological connection of which it 
is scarcely possible to account for. 

3. To the one-sided study of the effects of drugs in disease, 
which frequently differ from their true action on account of the 
alteration which has taken place in the conditions of the sen- 
sitive sphere, of the conducting power of certain nerves, or the 
reactive force of the organism. Hence it is that one and the 
same remedy will produce different effects, in different diseases; 
quinine, for instance, occasions at times diarrhoea, at times 
constipation ; calomel at times ptyalism, at others vomiting 
and diarrhoea, etc. The proving of drugs upon the sick leads, 
therefore, to the most contradictory results. The curative 
powers of a remedy in certain affections are extolled to the 
skies; if used by others in similar cases it is found unavailing. 
When a new remedy is discovered, it is employed at random 
in various forms of disease to find out its curative properties, 
and years elapse until they become somewhat remotely known. 
Kreasot, for instance, is used in this fashion by many phy- 
sicians, very much to the prejudice of more trustworthy re- 
medial agents. Another cause of our deficient knowledge of 
the pathogenetic and curative powers of drugs is, 

4. The habit of mixing up a number of drugs in one pre- 
scription. This habit has existed from time immemorial, and 
has probably originated in an endeavor to attain several the- 
rapeutic objects at once. Agreeably to the principle : "corpora 
non agunt nisi soluta" solid bodies are mixed with liquids in 
order that the former may be administered in a liquid form. 
The feeble action of some remedies is supposed to be strengthen- 
ed by the addition of similar drugs. Unnecessary secondary 
effects are supposed to be prevented by the admixture of other 
agents. Other agents are added in order to restore the various- 
ly misdirected vital forces to their original channel, or to re- 
move sympathetic affections, or to make the medicines more 


Many physicians have spoken for and against the mixing 
up of drugs. The greatest practitioners have generally been 
in the habit of using simple prescriptions. Hnfeland has de- 
fended the use of compound prescriptions, without, however, 
carrying it to excess. 

My own opinion on these subjects is as follows : 

(a) It would be strange if the simple chemical substances 
were the only ones in nature endowed with medicinal pro- 
perties. Mineral waters, which have such wonderful thera- 
peutic properties, are compound substances. Plants and salts 
are no simple substances. Hepar sulphuris, metallic oxydes, 
compound acids, etc., are compound artificial preparations of 
great therapeutic value, the effects of which we know from re- 
peated provings. 

(b) We possess several pharmaceutic compounds, which we 
cannot reasonably reject in practice, provided they are always 
prepared in the same manner, and their physiological effects 
are well known. 

(c) There are compounds which have become standing 
preparations in our pharmacopoeia, and which we have a right 
to retain because we are fully acquainted with their therapeu- 
tic use. Such preparations are, for instance, Calomel and 
Opium. Ammonia and Tartar emetic, Nitrum and Lauro- 
cerasus, Cinchona and Sulphuric acid, etc. 

(d) On the other hand it is entirely wrong to make medi- 
cal compounds as we sum up numbers, and to suppose that 
the effect of all the substances united contains the effect of 
each in its genuine form. Some of those substances may act 
in the compound as they do singly ; but as a general rule, the 
effect of the substances combined, is different from what it is 
speculatively intended. We know that acids and alkalies neu- 
tralize each other ; but we know very little of the modifying 
influence which the various ingredients of a medical compound 
exercise on one another. Any one who has an opportunity of 
seeing a number of prescriptions, may convince himself of the 
many mistakes which are committed in writing. them. I will 
mention some of them. 

Opium is decomposed by Ammonium, the extractive mat- 
ter and the narcotin being precipitated. 

Salts of copper are decomposed by syrup, and still more 
certainly by honey. 

By adding Prussic acid or even Laurocerasus to Calomel, 
we convert this substance into the cyanite of mercury, a vio- 
lent poison which has most probably caused the death of 


Calomel is frequently given incc-mbination with magnesia, 
which changes the former substance to the well known Mer- 
curius cinerens. 

Calomel and the golden sulphuret of antimony in combina- 
tion, give rise to sulphate of mercury (iEthiops mineralis). 

The union of tartaric acid and nitre is likewise condemna- 
ble, since it gives rise to nitric acid and tartar, the latter being 
precipitated in the shape of a white salt. 

It is as yet very little known that the action of Nux vomi- 
ca and Chamomilla is neutralized in a great measure by the 
simultaneous use of coffee, and that the action of Belladonna 
is increased to an extraordinary degree by vinegar. Chemists 
will probably account for this fact by stating that acids dis- 
solve the atropin as easily as quinine is dissolved by sulphu- 
ric acid, which if added to a decoction of Cinchona, increases its 
effects considerably. Alcohol, however, is likewise an ad- 
mirable dissolvent of Strychnine, and yet spirituous substances 
and Nux are in polaric opposition to one another. Chemistry. 
in spite of its wonderful advancement in modern times, is un- 
able to account for every thing. Hahnemann has recommend- 
ed small doses of the tincture of Belladonna as a preventive 
against scarlet fever, which has been confirmed by a great 
many physicians. By others, on the contrary, it has been de- 
nied. This will not appear strange, however, if we consider 
that the dissenting physicians, instead of using the tincture as 
recommended by Hahnemann, have employed the extract of 
Belladonna dissolved in Cinnamon-water. It is difficult to 
understand why that mixture should have been selected, unless 
it is to follow the rules of a blind routine which condemns the 
administration of single, unmixed medicines as want of skill. 

If physicians would endeavor to understand the fact, that 
the powers of remedial agents, are modified by mixing up a 
number of them, we should have a great many less reports of 
cures by means of compound prescriptions, leaving it doubtful 
what remedy effected the cure. Such reports are ridiculous, 
and yet our journals are constantly teeming with them. 

Physicians who are in the habit of using compound medi- 
cines, cannot comprehend the efficacy of single medicines, 
even when administered in very small doses. They can easily 
convince themselves of the power of those medicines to'affect 
the organism. Every day we use the common table-salt in our 
food without distinguishing its peculiar pioperties,and yet a very 
small portion of that substance, dissolved in pure water, would 
affect us very sensibly. Facts like these have led Hahne- 
mann to the theory of dynamization, or development of power 


by the progressive trituration and succussion of the drug. 
This doctrine will be examined hereafter. 

Section 57. 

Hahnemann has pronounced against all compound pre- 
scriptions, without, however, rejecting compound substances 
which are chemically united. By mixing up one drug with 
another, we modify their characteristic modes of action. Some 
homoeopaths have attempted to mix remedies, but this proceed- 
ing has entirely failed. There is no doubt, however, that com- 
pound prescriptions might be used with advantage in some 
cases, provided we had previously ascertained their pathoge- 
netic effects upon the healthy organism. 

The method of preparing homoeopathic remedies is so pe- 
culiar, that it requires a notice in this place. 

Section 58. 

The principal object in the preparation of homoeopathic 
remedies, is to divide and dilate them. 

Dry substances, such as earths, salts, sulphur, metals, ani- 
mal and vegetable charcoal, lycopodium, and some liquid or 
half-liquid substances, which are neither soluble in water nor 
alcohol, such as balsam of copaiva and oil of turpentine, are 
divided by triturating them with sugar of milk. One grain of 
the solid, and one drop of the liquid substances, is mixed with 
ninety-nine grains of sugar of milk, and triturated for one hour 
in a porcelain mortar with a porcelain pestle. Hahnemann 
lays down a certain number of minutes which is to be devoted 
to every stage of the triturating process. This seems to be 
somewhat pedantic. After one hour's trituration we obtain 
the first trituration. The second trituration is prepared by 
triturating one grain of the first trituration with an additional 
ninety-nine grains of sugar of milk. The third by triturating 
one grain of the second in a similar manner. Of this third 
trituration we mix one grain with one hundred drops of alco- 
hol or water, and, by shaking the mixture a number of times, 
obtain the fourth dilution. Every successive dilution is ob- 
tained, by mixing in a similar manner, one drop of the pre- 
ceding dilution with ninety-nine drops of alcohol. 

Hahnemann has laid down the general proposition, that 
the medicinal powers of drugs are developed by trituration and 
succussion, and therefore recommends ten strokes of the arm 
to make the first dilution, and two strokes for each succeeding 


one. It has been inferred from this minute indication of the 
number of strokes that any additional shaking would develope 
the medicinal powers of a drug to excess. Hahnemann him- 
self has asserted that the 30th dilution or attenuation of Drosera, 
if prepared with twenty strokes, might prove fatal to a child* 
Pious believers scarcely dared to set down a vial containing 
medicine, with any force, or carry it about with them in a car- 
riage, lest the shaking should impart to the medicine poison- 
ing powers. All this is mere imagination. 

Section 59. 

It is an undeniable factdliat the medicinal virtues of drugs 
are developed by dividing or breaking up their substance. 

This fact is abundantly conflrrflfed in the case of oyster- 
shells, earths, metals, and other substances, which either do 
not affect the organism at all in their crude form, or affect it 
very differently from what they do when properly divided. 
This phenomenon is too curious not to inquire into it a little 
more closely. In triturating and shaking a drug, two things 
take place : 

1. Rapid movement of the particles. 

2. Breaking up of the cohesion of the particles. 

We know from experience that these two processes, and, 
in many cases, each of them alone, develope the effects of the 
imponderabilia, light, heat, electricity, and magnetism. Light 
and heat are obtained by compressing the air suddenly. 
Phosphorescence is frequently the result of friction. Friction and 
sudden compression, as takes place in firing off a percussion 
gun, cause fulminating oxydes to explode ; in striking steel 
against flint the spark is obtained by means of friction. 

Friction developes the electric property of idioelectric sub- 
stances, silk, glass, resin, etc. 

Iron bars are magnetized by passes. The concussion by a 
stroke of lightning produces the same result ; another stroke 
across the line of the magnetic poles, neutralizes the magnet- 
ism so produced. Becquerel has shown that in splitting a 
regularly crystallized mineral, which is a non-conductor of 
electricity, the two surfaces so obtained show an excess of 
opposite electricities ; that the glass which has been pound- 
ed in a mortar of agate, tinges the juice of violets green ; that 

* These doctrines have been considerably modified by Hahnemann. 
See his preface to the fifth volume of the Chronic Diseases, translated 
by Charles J. Hempel, M.D. 


electricity is set free by rubbing a plate of mountain-crystal 
with a stopper covered with the deutosulphate of tin. 

The fact of powers becoming latent, is a remarkable phe- 
nomenon which we are not always able to trace to a principle. 
This phenomenon likewise occurs in animal nature. Passes in 
one direction quiet one, or put one to sleep ; counter-passes 
neutralize that effect. 

We are not able to show the extent of the influence which 
the movement of the particles in triturating or shaking a drug 
has on the development of its medicinal powers. I think, how- 
ever, that that influence has been overrated. I have become 
convinced, by repeated experiments, that the first trituration 
is sufficient to develope the medicinal virtues of a drug, and 
that the alcoholic dilutions which are prepared from the first 
trituration, are just as powerful as those which are prepared 
from the second and third. The great point is to break up 
the cohesion of the particles. 

With but few exceptions we may lay it down as a rule, 
that the denser substances which it is most difficult to dissolve 
and to oxydize, earths, gold, silver, and platina, manifest the 
smallest amount of medicinal power in their natural form. 
This may likewise be said of vegetable or animal charcoal, 
which has lost the properties of an organic substance in conse- 
quence of the burning. Metals which are more easily oxydiz- 
ed, copper, tin, iron, lead, arsenic, antimony, quicksilver ; the 
combustible substances, phosphorus, sulphur, petroleum ; iodine 
and the organic animal and vegetable substances, which, being 
products of a higher formative power, have on that account a 
greater dynamic affinity to the vital forces, are more capable 
of acting upon the organism in • their natural condition. 
There are also organic substances whose latent powers require 
to be developed by division ; of this number is the lycopodium, 
which, t in spite of the looseness of its particles, requires to be 
triturated and shaken in order to become an active remedial 

Our chemists do not know that platina, gold, silver, silica, 
and various other substances, can be dissolved in alcohol and 
water, after having been previously pulverized and mixed with 
other easily soluble substances. Any one may convince him- 
self of this fact at any time. Three grains cf the first tritura- 
tion of any of those substances, can be dissolved in one hun- 
dred drops of distilled water or dilute alcohol so completely, 
that, after shaking the solution for a time, it becomes perfectly 
clear ; no sediment or turbidity is perceived, even through a 
microscope, and the medicinal powers of such a solution are 


undeniable. This same observation has been abundantly- 
verified with oily and resinous substances, the balsam of copai- 
va, oil of turpentine, petroleum. Whatever reasons chemists 
may bring against the solvability of those substances, they are 
effectually met by practical experiments. Iron, tin, lead, cop- 
per, zinc, and other substances, are more or less oxydized du- 
ring the triturating process by the contact of the atmospheric 
air ; this renders them still more soluble. This is not the case 
with silica and the so-called noble metals ; if these undergo 
chemical changes during the process of trituration, we are not 
as yet acquainted with them. 

Section 60. 

Hahnemann applies the term "dynamization, or potency," 
to any attenuation, because, in his opinion, the medicinal pow- 
ers of a drug are developed by attenuating it. This term ap- 
plies properly only to the earths, and to metals of difficult 
oxydization, which contain their curative virtues in a latent 
state. It is my opinion, that these virtues are completely de- 
veloped in the first, clear, transparent dilution. Converted 
into such dilutions, the earths and metals are like other medi- 
cinal substances, which possess, in their natural form, the 
power of deranging the dynamic relations of the organism. 
Some agents possess this power in an extraordinary degree, 
compelling even alioeopathic physicians to prescribe very small 
doses, lest the organism should be injured. This circumstance 
is of itself sufficient to show that the power of a drug is di- 
vided in proportion as the drug is attenuated. If that power 
were increased by the attenuating process, every remedial 
agent would be converted into a deadly poison. 

Hahnemann calls the effect of a highly attenuated drug, 
" spiritual-dynamic." It would seem as if this meant an 
actual separation of the dynamic power from its material sub- 
stratum, and a transfer of that power to the attenuating vehicle. 
Such separations do exist. Warmth escapes from heated sub- 
stances, and is communicated to others. The electric fluid is 
transferred from the glass cylinder to the conductor, and from 
the conductor to the Leyden battery. An iron-bar is rendered 
magnetic by passing a magnet over it. The moon transmits to 
our earth the light which it had received from the sun, and there 
are substances which possess the power of absorbing light and 
shining in the dark. We are not yet certain, however, whether 
the basis of imponderabilia is a volatile substance sui generis, or 
whether imponderabilia are properties of substances excited into 


action. It is therefore premature to consider the action of highly 
attenuated drugs analogous to that of the imponderabilia, so 
much more as we are conscious of a communication of sub- 
stance in taking an attenuated drug. Such a communication 
takes place likewise when old people derive strength from 
sleeping with children. 

On the other hand, it would be wrong to consider high 
attenuations as nothing, because the medicinal substances 
which they contain do not react chemically. The chemical 
relations of magnetized iron are the same as those of other 
iron. The pestiferous miasm which poisons a bale of cotton, 
and converts it into a carrier of the plague, is no more capable 
of chemical reaction than an arsenic-atom in the tenth atten- 
uation, which we know to act with decided benefit in. the pro- 
per place. I say, in the proper place ; for high attenuations 
only act when the nerves are in a proper state to receive their 
influence. Forces act most intensely, where dynamic opposi- 
tions and polaric relations take place. The magnet does not 
act upon a grain of gold, but it draws a molecule of iron 
from amidst a heap of gold-dust. The multiplier is not moved 
by light or warmth, but the feeblest galvanic current is sufficient 
to set it in motion. The chloride of silver is not altered by an 
electro-galvanic current, nor by heat ; a ray of light, however, 
blackens it. Sulphuretted hydrogen acts upon the smallest 
portion of arsenic or sugar of lead contained in a solution. 
Because nitric acid does not act upon the cyanite of mercury, 
would we maintain on that account that it does not react at all? 
Or would we deny the fecundating power of the spawn of frogs, 
which retains this power even if highly diluted, for no other 
reason than because other animals are not fecundated by it ? 

There is no doubt that in some instances the attenuating 
process has been carried too far. It has been asserted that 
medicines do still act in the 1500th attenuation. 

The effects of such high attenuations seem to me rather 
imaginary than real. The efficacy of the 30th attenuation of 
many drugs has been confirmed by too many observations to 
admit of any doubt. Even the 45th and the 60th attenuations 
of Belladonna have cured encephalitis in my own practice. I 
may here observe that by lower attenuations I understand the 
first, second, third, and that I consider attenuations higher 
as we progress in the scale of numbers. 

Section 61. 

It has been known for a long time, that large doses act 
differently from small ones. Large doses produce primary 


effects more rapidly and more distinctly ; the more so, the 
more heterogeneous the medicinal substance is to the organism. 
Large portions of a drug excite violent reactions in the repro- 
ductive sphere, which do not occur after giving small doses, 
though they may have sufficient power to act dynamically 
upon the sensitive sphere. 

Hahnemann thinks that the dynamized homoeopathic agent 
acts like a spiritual substance. This term " spiritual" is badly 
chosen. By a spiritual thing, we understand something im- 
material, something purely psychical. The homoeopathic 
agent is something material, though it may be ever so little. 
The action of a homoeopathic agent has been compared to that 
of a miasm. This cannot be considered objectionable. Mias- 
mata are substances, no matter whether their existence can be 
proved or not. The atom of pest-miasm, which is detached 
from the clothes of the patient by merely touching them, and 
infects a healthy person with that disease, cannot possibly 
pass at once into the circulation, and poison the whole volume 
of the blood. The blood is indeed altered, but not primarily. 
The alteration proceeds secondarily from the sensitive sphere 
by which the dynamic disturbance is first perceived. tSchur- 
rer, who is a well known opponent of the specific school, says 
in his " Theory and Practice of Medicine," that medicines act 
most powerfully when given in small doses. In this case, 
their direct action upon the intestinal canal is very inconsider- 
able ; they effect the secundae vise of the organism, the blood 
for instance, where they become latent, and give rise to changes 
which resemble a reproductive process. This reminds us in- 
voluntarily of the phenomenon discovered by Berzelius, and 
known in English books on chemistry, by the term " action of 
presence ;" by virtue of this law (" catalysis" or catalytic action) 
certain substances occasion, by their mere presence, changes 
in other substances without being themselves changed, or with- 
out being intimately combined with the latter. According to 
Rung J s discovery, lead delays the solution of other metals, 
and particularly of zinc, in sulphuric acid, without being itself 
altered. Drayer remarks that the affinities of inorganic 
chemistry have no effect in animal chemistry. The kidneys 
secrete the urine from the blood without the intervention of a 
reagent. Inorganic chemistry acts by substituting one element 
for another. This is quite different in organic chemistry. 
The decompositions are effected by means of the peculiar 
arrangement of the organic tissues, or by the mere presence of 
an inherent substance which remains unaltered itself. The 
principle of catalytic action is still very obscure ; but there 


can be no doubt that the atom of a contagium and the 30th 
potency of a grain of arsenic do not act analogously to a 
chemical reagent, and that their influence is first perceived by 
the sensitive sphere, whence it gradually invades the whole 

Section 62. 

It is important that the quality of our remedies should 
not be subject to changes. 

The medicaments from our pharmacies frequently show 
great differences, and therefore act differently. A slight omis- 
sion in the preparation of a remedy frequently changes it to 
something entirely different from what it was intended to be. 
Of great importance is the temperature of the water used for 
infusions, the length of time employed for the preparation of a 
decoction, or for the evaporation and inspissation of an extract, 
the nature of a glass stopper, which, if it does not fit tightly, 
allows volatile substances to evaporate, and does not prevent 
the injurious access of the atmospheric air. Hence so many 
complaints about the uncertain effects of remedies. Hahne- 
mann has proposed a very simple proceeding to remedy those 
defects. He tells us that remedies prepared according to his 
rule, will keep for years without undergoing any change. 
Even a powder moistened with the 30th potency of Phos- 
phorus is supposed by Hahnemann to remain unchanged for 
years. This seems in the highest degree improbable and con- 
trary to the laws of nature. It is inconceivable that we should 
have it in our power to separate a property from its substance, 
and to communicate that property to some other substance, 
without it being in any degree altered by the nature of the 
latter. Reason tells us that power and substance modify each 
other, and we know from experience that the transformation 
of a substance occasions a modification of its virtues. The 
life of nature consists in a perpetual alteration and transforma- 
tion of substances and powers, which can only be arrested un- 
der certain circumstances, for instance, by keeping a thing in 
a hermetically sealed bottle. Otherwise every thing changes, 
either by its own nature, without any other apparent cause, or 
by the disturbing influence of some foreign agent. 

It is the duty of the pharmaceutist to furnish remedial 
agents in as pure a condition as possible. He ought therefore 
to know what influences are hurtful to them in order that he 
may be able to afford them the necessary protection. This 
seems to have been overlooked by Hahnemann and by some 


authors of homoeopathic pharmacopoeias. Nevertheless a con- 
siderable number of our remedies are liable to great changes. 
Many of them are by no means what they are supposed to be. 
The Calcarea carbonica which we prepare from oyster-shells, 
is by no means pure lime, but contains phosphoric acid. Hav- 
ing been used in the provings upon the healthy body, it would 
be wrong to substitute in its place pure lime, the effects of 
which would be somewhat different from the above named 

I will state a few facts to show how necessary it is that 
our remedies should be prepared with more care than seems 
to be deemed necessary by the pharmaceutists of our school. 

Metals from different mines are alloyed with various sub- 
stances, which require to be carefully separated lest the metals 
should not exhibit the same effects. 

The gold and silver used by binders are pure substances, 
which, if triturated with sugar of milk, will always furnish the 
same preparations. 

It. is more difficult to obtain Platina pure. It can be ob- 
tained, however, by boiling the chloride of platina with alcohol, 
the pure metal being precipitated during the process of ebullition. 
It is perfectly proper for use after it has been washed a num- 
ber of times with distilled water. 

The pulverization of Zinc is a difficult thing. It is laid 
down as a rule to rub zinc under water on a fine stone, and 
to collect and dry the powder which falls to the bottom of the 
vessel. This powder is mingled with impurities from the stone. 
It is much better to use a fine English file in pulverizing zinc ; 
I have convinced myself that the zinc thus prepared remains 
entirely unmixed. At any rate, a magnet dipped into the pow- 
der does not attract a single particle. The zinc thus pulverized 
can be triturated with sugar of milk ever so finely, and may 
afterwards be dissolved in water. Stannum is generally 
mixed with Arsenic, from which it is separated with difficulty. 
The most certain way to accomplish this is to triturate tin-foil 
with the nitrate of potash into a fine powder and to detonize 
the latter. In doing this arseniuretted potash is formed, which 
is removed by frequent washing. The remaining substance 
is heated in a crucible, and the pure metal /Stannum remains 

Pure Lead is obtained by heating and shaking the acetate 
of lead in a glass retort, the pure metal being precipitated 
during the shaking. 

Copper is obtained pure with great ease. The acetate of 
copper is to be heated and a stream of hydrogen passed upon it. 


Pure Iron may be obtained from the substance known as 
Crocus Martis aperitivus, which is to be freed from copper by- 
passing a stream of hydrogen upon it. That preparation is so 
susceptible of oxydation that it burns spontaneously unless at 
once put up in a well-stopped flask. 

Mercurius solubilis is an extremely uncertain preparation, 
and is never the same, wheresoever and howsoever it may 
have been prepared. 

Corrosive sublimate is changed to calomel when triturated 
with organic substances. The triturations are condemnable, and 
no preparations of that substance ought to be used except the 
dilutions with distilled water. 

Iodine undergoes essential alterations by mixing it with 
alcohol or by triturating it with sugar of milk, and therefore 
ought to be diluted with water. Water, however, dissolves 
only a small portion of Iodine. A thousand drops of the most 
carefully prepared solution of Iodine in water contain only one 
grain of this substance. 

Hepar sulphuris is easily decomposed by attracting oxygen 
from the atmospheric air, and gradually changes to the sulphate 
of potash. 

Hepar sulphuris calc. is likewise a very sensitive sub- 
stance. An alcoholic solution of that substance in small glass 
flasks with narrow necks and hermetically sealed, keeps a long 
time. The Spiritus nitrico-aethereus has to be preserved in 
the same way. 

Phosphorus is a very changeable substance. If triturated 
with sugar of milk, it changes to phosphoric acid in a very 
few hours. Phosphorus keeps longest in a solution with sweet 
oil. 1 employ a solution of phosphorus in ether, kept in a re- 
tort the neck of which is closed by melting ; I prepare the 
attenuations at the time when I wish to use them. 

Mineral acids ought to be attenuated with distilled water, 
not with alcohol. 

Sulphuric acid with alcohol changes to Acidum sulphuri- 
cum vinosum. 

Nitric acid with alcohol to iEther nitricum. 

Muriatic acid with alcohol to light vEther muriaticum. 

Phosphoric acid is readily changed to Acidum phosphori- 
cum vinosum by an admixture with alcohol. 

In triturating medicinal substances in porcelain mortars 
particles of the latter are rubbed off. This is of no im- 
portance, however, since our provings have been instituted 
with the substances so prepared. Messerschmidt proposes 
to make the triturations in vessels made of sugar of milk. 


By adopting this ingenious proceeding, all admixture of he- 
terogeneous particles would be avoided. 

Distilled water from the shops cannot be relied upon, be- 
cause every kind of distilled water is prepared in the same 
apparatus. A physician who wants to be sure of having his 
medicines pure, ought to distil the water he uses, in his own pri- 
vate retort, and ought likewise to distil his own alcohol. He will 
be sufficiently rewarded for his trouble, by the consciousness of 
having reliable preparations. As regards sugar of milk, it is 
a matter of course that none but purified sugar should be used. 

On the other hand, we can be too fastidious in preparing 
our medicines. Hahnemann advises to use a particular vial 
for every attenuation. If the vials be properly washed, boiled, 
wiped with a sponge attached to a whalebone, then washed 
again and heated in a stove, they are perfectly clean, and may 
be used for other attenuations. 

The paper which is used for the powders, should be free 
from chlorine, and should not smell of bad glue. 

As. regards the pellets used by Hahnemann, a good deal 
has been said for and against them. They are the little grains 
made by confectioners of sugar and tragacanth. Having been 
moistened with the medicine, they are put up in vials. Our 
pocket-cases generally contain such pellets. Pellets moistened 
with the attenuations of earths, metals, potash, Natrum, various 
salts and vegetables, keep for a number of years. Volatile 
substances, camphor, ammonium, turpentine, musk, are less 
durable. Pellets moistened with such substances, have to be 
saturated over again repeatedly, particularly in summer. If these 
precautions be observed, the pellets are extremely convenient in 
our daily practice. I do not count them very anxiously, and 
sometimes give 20 or 30, nor do I use them exclusively, but 
employ tinctures and higher and lower potencies as the case 
may require. It makes no great difference in what form med- 
icines are given, provided they are mixed with a vehicle which 
will interfere as little as possible with the nature of the remedy. 
If the medicine is to be used repeatedly at short intervals, it is 
best to give it in water. 

Section 63. 

The proving of drugs upon the healthy is of the utmost 

Almost all we know of the effects of drugs upon the healthy, 
is derived from cases of poisoning. Hahnemann has shown 
that it is of the utmost importance, in the specific method of 
healing, to know those effects with the utmost accuracy. To 



obtain that knowledge, the proving has to be conducted ac- 
cording to certain rules. 

Section 64. 

1. The provings have to be frequently repeated. 

Empirical truths, to which the results of our provings be- 
long, only become valuable by confirmation. It would be an 
egregious mistake, to consider every abnormal sensation which 
is experienced after taking the drug, a result of its action. Mor- 
bid sensations of little consequence, are felt constantly without 
any apparent provocation. Many of them have probably been 
incorporated in our Materia Medica. Hence the necessity of re- 
peated provings ; in this way we shall finally succeed in sepa- 
rating the essential from the accidental symptoms. 

Section 65. 
2. The provings must be instituted on males and females. 

Unless persons of both sexes are subjected to the proving 
of drugs, we cannot become acquainted with the specific re- 
lations of drugs to the sexual apparatus. 

Section 66. 

3. The 'provings must be instituted on persons of different 

It is scarcely necessary to mention reasons. Cantharides 
and Agnus castus do not act upon an old man as they do upon 
the young, and Sabina affects a fully developed woman differ- 
ently from a child. 

Section 67. 

4. It is advisable to observe the temperaments and dispo- 
sitions of the provers. 

We know that many drugs will produce different results, 
in persons of different temperaments. It would be desirable 
if every medicine were proved with reference to temperament, 
or peculiar habits of the constitution. Some persons are af- 
fected with a headache, when their health is disturbed ever so 
little. Others are inclined to colic, diarrhoea, catarrh, etc. 
Such peculiar dispositions must necessarily affect the action of 
the drugs upon the prover. 


Section 68, 

The effects of drugs have to be observed in all possible 
conditions and circumstances. 

We know that, under certain circumstances, the action 
of the drugs is increased, diminished, or neutralized. A glass 
of wine, which perhaps would not affect a man if he sat down 
quietly after drinking it, might intoxicate him, if he were 
to ride out in the open air. An indigestion might often be pre- 
vented by taking some pleasant exercise after a meal, instead 
of sitting down to serious study. It is the same with the ef- 
fects of drugs. Some drugs act better in the morning, others 
in the afternoon, evening, or at night ; some drugs show their 
effects better during rest, others during motion, some in the 
open air, others in a closed room, some in cold, others in warm 
weather. These things have to be observed with care, but 
"without pedantry. If we read, toothache while playing on the 
violin, we are not to infer that the music excited it, but that 
it arose from the increased rush of the blood towards the af- 
fected part, in consequence of the upward motion of the arm. 
It would be desirable if the same drug were taken by a suffi- 
cient number of prove rs, at different hours of the day, to enable 
us to observe the effects it would exhibit at different periods, 
and in different conditions of the mind and temper. The ab- 
sence of the effects which a fright, chagrin, cold, etc., usually 
occasion in a person, may likewise afford an important thera- 
peutic indication. 

Section 69. 

Provers of drugs must enjoy good health at the time of 

Both the body and the mind of a prover must be in a sound 
condition. Provers must not possess an inordinate imagina- 
tion, lest trifling symptoms should be construed into important 
physiological effects. 

Section 70. 

The action of the drug must be as little as possible dis- 
turbed by heterogeneous influences. 

Provers must subject themselves to a rigorous diet, avoid 
coffee, tea, spirits, spices, asparagus, celery, parsley, onion, 
garlick, radishes, old cheese, acids, mineral waters, the use of 


tobacco in any shape, violent exertions and emotions, and they 
must always live in a pure air. Persons accustomed to stim- 
ulants of any kind, are unfit for the business of proving. 

Section 71. 

Drugs must be taken in sufficiently large doses to make 
their primary effects distinctly perceptible. 

Human life should, of course, not be hazarded in proving. 
The portions of the drug to be proved must be large enough, 
however, to induce the greatest possible variety of symptoms 
of reaction in the organism. High potencies are unfit for pur- 
poses of proving. If they develope symptoms, it is owing to 
some peculiar idiosyncracy from which no general rule can be 

Section 72. 

To have a perfect knowledge of the effects of drugs, we 
must be acquainted with the dynamic alteration produced by 
them in the organism. 

The provings instituted by Hahnemann and some of his 
disciples, are mere records of symptoms. Good and bad are 
mixed up in those records. The symptoms recorded in the 
Materia Medica Pura, furnish admirable delineations of the 
action of drugs, but there are many symptoms which are evi- 
dently accidental, such as itching of the lobule of the ear, 
yawning after dinner, going to sleep of a foot, etc. Such and 
similar phenomena are entirely valueless unless they should 
be experienced by a number of provers. In a second proving 
of the drug those symptoms do not appear, but other equally 
insignificant symptoms occur in the place of the former 
They may sometimes result from the action of the drug, as 
sympathetic effects, but, in any case, ought to be carefully 
separated from the positive effects of the drug, which are ob- 
served in all or most of the provers. The positive effects will 
enable us, by means of physiology and pathology, to under- 
stand the character of the dynamic condition occasioned by 
the drug. 

Section 73. 

The order in which the symptoms make their appearance, 
should be particularly noticed. 

It is important to know what are primary, sympathetic and 
counter-effects. The primary effects are the more permanent. 


the sympathetic effects are less frequent, depending upon indi- 
vidual conditions. Counter-effects proceed from the organism, 
and neutralize the former. The primary effect of Rhubarb is 
diarrhoea ; if this be attended with constriction of the chest, 
this latter symptom would be sympathetic, depending upon the 
sensibility of the par vagum and the sympathetic nerve, which 
is not the same in every individual. The costiveness succeed- 
ing the diarrhoea, is a counter-effect. 

Section 74. 

It is equally important to observe the effects which medi- 
cines have on particular organs. 

Those effects can only be studied by attentive observation. 
We know from experience that Camphor acts upon the brain, 
Nux vomica on the ganglionic system, Ipecacuanha on the 
stomach, Jalappa on the intestinal canal, Mercury on the 
glands, Digitalis on the heart and the urinary organs, etc. 
Other drugs seem to act upon a particular system, the sub- 
sequent local affections depending upon the sensibility of the 
affected parts, which differs in different individuals. Alcohol 
increases the activity of the arterial system,and the haemorrhages 
which it occasions, depend upon the accidental condition of 
the bleeding organ. Sabina is distinguished for its specific 
action on the uterus. Since we have to act specifically upon 
the affected organ, it is of course indispensable that we should 
be acquainted with the particular effects of drugs upon particu- 
lar organs. 

Section 75. 

It is of importance to investigate the mode in which 
medicines act dynamically. 

This is a very difficult point, which the founder of our art 
has omitted to investigate. Reason, however, is not content 
with a merely mechanical exhibition of our remedies. Though 
we cannot explain every thing, is it therefore improper that 
we should endeavor to perfect our understanding? 

It is not sufficient to know that a drug affects a particular 
organ or system. We require to know how the parts are af- 
fected dynamically. This is accomplished by means of the 
understanding with which we embrace the totality of the 
symptoms, and by means of the reason with which Ave en- 
deavor to perceive the natural and therefore necessary internal 


connection of the symptoms. The idea of sensibility, irrita- 
bility, and reproduction, is founded in reason. Although these 
three directions of the vital power are no material manifesta- 
tions, yet their conception by means of the reason is just as natu- 
ral as the idea of gravitation and centripetal force, upon which 
our reason founds the construction of our solar system. Ex- 
perience has pointed out those three divisions of the vital force, 
and it is assuredly no idle speculation to suppose that all the 
varied manifestations of vitality depend upon those three 
properties of the vital principle. Sensibility, irritability, and 
reproduction, are so intimately united that it is very difficult 
to trace a precise line of demarcation between their respective 
functions. Many of these functions, however, belong evident- 
ly to one or the other of those three spheres. In studying 
them separately our attention will necessarily be directed to 
the disturbances which occur in either of those spheres, and 
to the causes which occasion the disturbances. Inasmuch 
as drugs belong to those causes, it behooves us to distinguish 
the eifects of drugs in the respective orders or spheres of the 
vital force. This will, of course, lead us to analyze the phy- 
siological action of drugs upon particular organs. By such 
means we have obtained the outlines for the science of phar- 
macodynamics. Although it is as yet very incomplete, yet, 
by carefully continuing our provings, the science will be en- 
larged for the benefit of the healing art. 

Section 76. 

We do not yet possess a true science of pharmacodynamics, 
viz , a systematic arrangement of specific remedies, together 
with an indication of their specific virtues. 

All we possess, are fragmentary indications of the dynamic 
action of drugs, and the physician who desires to practise as 
a rational being, has to disentangle the chaos of the symptoms, 
to separate essential and constant from accidental effects, and 
to obtain a clear perception of the dynamic action of a drug, 
by means of combination and reflection. This result can be 
accomplished, in so far as it is possible in the present imper- 
fect state of our knowledge, by proceeding systematically ac- 
cording to certain rules, which it may not be inexpedient to 
note in this place. 

Section 77. 

To obtain a certainty in regard to the effects of drugs, we 
have to observe the following rules. 

1. The symptoms which have been observed on the dif- 


ferent provers, have to be compared with one another, those 
which recur in the statement of every prover, are of course to 
be considered positive effects of the drug. 

2. The order in which the symptoms succeed each other 
has to be carefully observed, and we have to determine by 
comparison, what constant symptoms recur in one and the same 

3. These constant symptoms have to be studied physiologi- 
cally, with a view of ascertaining whether the sensible, irri- 
table, or reproductive sphere is principally affected. 

4. The symptoms which indicate a particular relation of 
the drug to particular organs, have to be distinguished more 

5. The symptoms which recur more frequently, have to be 
distinguished from those which only appear occasionally. 

6. Lastly, we have to note the symptoms indicating a gen- 
eral invasion of the organism. 

By observing these rules, we shall not find it difficult to 
determine the true essential effects of drugs, and to explain 
physiologically the morbid processes which the drugs occasion 
in the organism. 

Aconite, for instance, increases primarily the action of the 
arteries, and of the fibrous tissues, occasioning, on account of 
this exclusive action upon the arterial circulation, a relative 
passivity in the venous system, with consequent congestions 
characterized by inflammatory phenomena. 

Belladonna produces similar phenomena, with this dif- 
ference, that it does not affect the arterial circulation directly, 
but indirectly by means of an increased action of the central 
points of the nervous system, with increased expansion from 
within outwards, occasioning inflammatory phenomena in the 
peripheral system. 

Bryonia excites the peripheral system of nerves and ca- 
pillaries, occasioning phenomena partly of an inflammatory, 
partly nervous character. 

Nux vomica excites primarily the contractive pole of the 
ganglionic system, occasioning congestions, and plethoric phe- 
nomena in the respective organs, with increased sensibility of 
the cerebral and peripheral system of nerves. 

Pulsatilla has a specific action on the digestive organs, 
occasioning moreover an increased sensitiveness of the periphe- 
ral system of nerves, attended with an increase of venous action. 

Digitalis diminishes the beats of the heart, and stimu- 
lates, upon a principle of antagonism, the secretive functions of 
the kidneys. These few indications may suffice. Careful 


observers will perceive that drugs produce opposite effects in 
organs which are in polaric opposition to each other ; though 
it may be difficult to account for the particular, or rather 
specific mode in which those organs are acted upon. We do 
not know why Belladonna occasions smooth eruptions, Aco- 
nite a sort of rash, Rhus vesicles filled with lymph, Dulca- 
mara suppurating and scurfy eruptions, or why Aconite, Bel- 
ladonna, and Nux affect moreover the inner parts of the 
throat. Inasmuch as every phenomenon in nature is the 
result of fixed laws, we cannot suppose that drugs act arbi- 
trarily, but we must admit that the phenomena which we 
observe in our provings, are reactions resulting necessarily 
from the mode in which the organism was originally affected 
by the drug. Our physiological knowledge, however, is as 
yet too imperfect, to enable us to understand the rational con- 
nection of the effects of drugs. For the present we have to 
content ourselves with an empirical knowledge of the cardinal 
effects of drugs upon the organism ; we know from experience 
that Iodine affects the glands, Cantharides the uropoetic 
system, Agnus castes the sexual organs, Petroselinum and 
Cannabus the mucous membrane of the urethra, Rhododen- 
dron the synovial membranes and aponeuroses, Stramonium 
and Aurum the mind, etc., and we know moreover by our 
provings, that those drugs affect the parts upon which they act, 
in a definite manner. 

I cannot pretend to say whether, at some future time, we 
shall be able to classify our drugs, with reference to their dy- 
namic character. To accomplish this it will, in the first place, 
be of paramount importance, to make our provings as complete 
as possible ; :it is only upon a most complete and accurate 
knowledge, of the effects of drugs upon the healthy organism, 
that a true system of physiologico-pathological pharmacody- 
namics can be constructed. 

Section 78. 

If we are well acquainted with the primary effects of drugs 
upon the healthy, we are able to determine the range and 
nature of their curative powers. Before Hahnemann had 
ever treated a cholera-patient, he recommended Camphor as a 
specific remedy for that disease, simply upon the ground of 
similarity between the pathogenetic effects of Camphor in the 
healthy organism, and the symptoms which were related as 
characteristic of the cholera. Hu.feland asks in the 11th of 
.of his journal, 1830, whether Arsenic might not prove a 


homoeopathic remedy for Cholera ? This question was founded 
upon his knowledge of the primary effects of Arsenic. Arsenic 
has indeed proved a specific for cholera ; many owe the pre- 
servation of their lives to Arsenic. 

Section 79. 

The object of treatment is to completely remove the dis- 

It is frequently impossible to attain this result. Among 
the obstacles which baffle the efforts of art, the following de- 
serve particular notice. 

1. Organic malformations, giving rise to pains and, irregu- 
larity of certain functions. Headache, arising from an exostosis 
in the cranium ; epilepsy, from tubercles in the brain ; arrest of 
the circulation, from a polypus in the heart ; cardialgia and 
vomiting, arising from a fully developed cancer of the stomach, 
are incurable affections. 

2. Exhaustion of the vital forces by age, excessive exer- 
tions, loss of animal fluids, or intense pain. 

3. Prostration of the vital forces which are too feeble to 
react against the morbific agent ; under this head belong those 
cases of typhus perniciosus, plague, cholera, etc., which de- 
stroy life in half an hour, poisoning by certain kinds of ani- 
mal or other poisons, etc. 

4. Continued action of hurtful influences which finally over- 
whelm the vital power ; for instance, grief from unfortunate 
love ; home-sickness in exile ; remorse, or unavoidable expo- 
sure to an unfavorable climate, etc. Wherever such causes 
do not oppose the treatment, it ought to be directed against 
the disease, as an individual case, taking into consideration 
both the external and internal character of the disease. 

It has been said that the homoeopathic treatment removes 
only the symptoms, but not the disease. This accusation is 
unfounded. Besides, if such a thing were possible, the symp- 
toms and the disease must be two different things. Symptoms 
are the reflex of some abnormal internal condition, without 
which there can be no symptoms ; these disappear only after 
the former has ceased to exist. It is highly condemnable, 
however, to direct our treatment against the proximate cause 
or internal disease, of which the symptoms are the perceptible 
manifestations, and, at the same time, against certain symp- 
toms in particular. This is especially objectionable if reme- 
dies are employed which do not correspond to the general dy- 
namic condition of the sick organism. Such a remedy is, for 


instance, Opium when administered for diarrhoea, or a particu- 
lar pain as subordinate symptoms. Large doses of the drug, 
if frequently repealed, may destroy the sensitive sphere. 

Section 80. 

The first general therapeutic rule is, Remove all mor- 

This rule is recognized by every school in Medicine, ex- 
cept that it is more or less comprehensively applied in prac- 
tice. Many diseases disappear simply by removing the mor- 
bific influence. A complete enumeration of all known mor- 
bific influences, would extend this work to an unnecessary 
length. At his first visit, the physician will seldom be able 
to point out all the injurious influences which threaten the 
patient's life. Some of them are of a spiritual nature, and can 
only be communicated to a physician who enjoys the full con- 
fidence of the family. A comforting word, a sympathetic look, 
a good advice, a friendly interposition in case of a dispute, are 
sometimes of more avail than medicine. Among poor patients, 
a little present, a load of wood, or some provisions for the win- 
ter, are sometimes the most useful means for the restoration of 
health. Some time ago I treated a man, who, for some trespass 
or other, had been sent to prison, and had become insane in con- 
sequence of having lost his honor. I do not believe that I 
should ever have succeeded in curing that patient, if I had 
not prevailed on the Judge, and on other persons whose good 
opinion was dear to the patient, to converse with him kindly, 
and to show him by their actions that he had not lost their 
good opinion. In many cases it may be sufficient, for the res- 
toration of health, to sleep in another room, to do without some 
hurtful article of toilet, to abandon some bad habit, such as 
smoking or chewing, devouring one's meal in too great a hurry, 
stooping too much when writing, etc. Tramzel treated a case 
of obstinate headache, which disappeared after a cherry-stone 
had been removed from the ear. 1 have treated a boy of 14 
years, for a violent and obstinate headache, which came on in 
paroxysms every morning. The boy was in the habit of 
washing his head with cold water immediately after rising 
from bed in the morning. I directed him to let an interval of 
15 minutes elapse between the rising and washing ; this sim- 
ple precautionary measure was sufficient to cure the headache 
entirely. Some years ago I treated a farmer, who was every 
morning attacked with vomiting and retching, and had a very 
bad taste in his mouth. He did not drink, but was a great 


smoker. After an ineffectual treatment of some weeks, I dis- 
covered that he smoked out of a wooden pipe, with a copper 
cover and very short stem. The pipe, which was penetrated 
with the acetate of copper, smelled horribly. By my directions 
he substituted a porcelain pipe for it, with a long stem, and 
got well in eight days. Many a rheumatic lady does not get 
well of her rheumatism, because she does not want to give up 
her favorite seat near the window, where she is is constantly 
exposed to a fine current of air, through a scarcely perceptible 
aperture. I might add a number of similar observations, but 
the few which 1 have offered will suffice to show the necessity 
of making such inquiries as have been alluded to above. 

Section 81. 
Internal morbific influences ought likewise to be removed. 

By such influences I understand all those hurtful substan- 
ces in the body which have been introduced from without, or 
have originated in the interior of the body. The founder of 
the specific method has acknowledged the necessity of remov- 
ing poisonous agents by means of an emetic, but he denies that 
any such necessity exists in overloading the stomach, because 
then the organism endeavors to relieve itself by spontaneous 
vomiting. If the effort to vomit be ineffectual, Hahnemann 
advises to tickle the palate with a feather, in order to facilitate 
the vomiting, and to take a cup of black coffee, which will se- 
cure the discharge by the bowels of the remaining contents of 
the stomach. Generally, however, he thinks that, even in 
case the stomach should be overloaded, a dynamic disturbance 
of the stomach is the cause of the indigestion, and that this can 
be cured by simply administering a remedy which is homoeo- 
pathic to the abnormal state of the stomach. 

All this is, for the most part, true. Many cases of indi- 
gestion, characterized by coated tongue, fetid smell from die 
mouth, offensive eructations, painful nausea and ineffectual 
urging, have been cured, as by magic, by simply restoring the 
tone of the stomach by means of a specific remedy. I have 
seen such results in my own practice too often not to rebuke, 
with just indignation, certain presumptious opponents of ho- 
moeopathy, for the insolent boldness with which they declare 
every thing that has been said in favor of homoeopathy, a piece 
of falsehood and deception. After rapidly curing such an indi- 
gestion, I have frequently been asked what had become of the 
impurities which had given the patient so much trouble a little 
while ago. It is likewise true that coffee has an excellent 


effect in slowness of digestion and interruption of the regular 
evacuations from the bowels ; but that action is not homoeo- 
pathic, it is enanthiopathic, in accordance with the principle, 
contraria contrariis. I mention this by way of advice to those 
who condemn every kind of antipathic treatment without 
rhyme or reason. 

The proposition to tickle the palate with- a feather in case 
of ineffectual urging to vomit, will find little favor. For my 
own part, I reject it entirely ; such a mechanical irritation is 
much too violent, and has, to my knowledge, resulted, in some 
cases, in a painful and difficult vomiting of bloody mucus. 
The irritation of the stomach, which is induced by the feather, 
is one proceeding from the nerves of the pharynx, and is con- 
siderably diminished on its passage to the stomach, on which 
account vomiting is frequently prevented in spite of the irrita- 
tion arising from the tickling, by a violent, antiperistaltic mo- 
tion of the oesophagus. I do not see why a safe emetic should 
not be administered under those circumstances. If any thing 
nauseating or indigestible have been introduced into the sto- 
mach, the shortest and simplest way to relieve the stomach is 
to take an emetic. In many cases it is sufficient to take a few 
glasses of tepid water in which a little fresh butter has been 
dissolved. If this have no effect, a few doses of Ipecac at in- 
tervals of from ten to fifteen minutes, succeeded by a few cups 
of tepid water, will certainly produce the desired result. A 
cup of black coffee taken a few hours after will restore the 
tone of the stomach to its former vigor. I have elsewhere re- 
lated a case of obstinate cardialgia, which was finally cured 
by an emetic. A piece of tough sward was thrown up, which 
had caused all the trouble, and had been swallowed several 
years previous. This is not homoeopathic treatment, nor is it 
opposed to it. The treatment, in that case, was based upon 
the universally recognized and universally valid principle, 
Tolle causam. If we keep that principle in view, we shall 
not be tempted to abuse emetics, and to employ them for the 
removal of so-called crudities, arising from weak digestion. 
In all such cases emetics are of no avail. Even if tenacious 
substances be thrown up, the relief is of short duration, inas- 
much as the pretended crudities are soon present again. Nor 
can coryza be cured by blowing the nose, or a catarrh by ex- 
pectorating; the cure must be effected by moderating the ex- 
cessive secretion of mucus. Hence it is that mucous fevers 
are never cured by cathartics, but by specific remedies which 
restore the depressed vital action of the mucous membranes. 

If the stomach be surcharged with bile, ought the bile to 


be removed? Most certainly, but not by emetics. Dmmling, 
Van Hoven, and particularly Reil, have refuted the notion 
that fevers are caused by an effusion of bile. It has been ob- 
served that the patients threw up a sour, acrid, corrosive bile, 
and from this fact it has been inferred that artificial evacua- 
tions are required, in order not only to free the stomach from 
its chemically destructive contents, but to prevent their absorp- 
tion in the intestinal canal, and a consequent general corrup- 
tion of the humors. The abnormal condition of the bile arises 
from an abnormal state of the secretory functions of the liver ; 
as long as these functions remain disturbed, the bilious pheno- 
mena will likewise continue. Moreover, the inherent vitality 
of the stomach is the best preventive against the chemical 
effects of the bile. Reil confesses that he has cured many 
cases of disease without cathartics, where he had used them 
formerly. The success of the treatment in such cases depends 
upon the fact that the dynamic disturbance had been removed. 

Section S2. 

The same remarks apply to infarctions of the intestines. 
Remedies, whose primary action is derivative, generally afford 
rapid relief; but then the opposite state sets in, and the bowels 
again become costive. I will not deny, however, that there 
are cases where a cathartic has to be used, even if a recurrence 
of the costiveness should have to be apprehended. Two years 
ago I treated a man who had been suffering for five days with 
constipation, excessive distention of the abdomen, pain, and 
increased anguish of death. Several homoeopathic remedies 
were tried without effect, and the anguish went on increasing. 
I then directed the patient to take an ounce of Oleum Ricini in 
two doses within six hours ; this procured an enormous evacu- 
ation with several hundred cherry-stones, which would most 
probably have remained in the bowels, if I had continued the 
use of homoeopathic remedies. The patient was perfectly 
well on the day following. Similar cases may occur again. 
I have cured numberless cases of obstinate constipation with 
small doses of Opium, Sulphur, Nux vomica, Veratrum, Alu- 
mina, and other remedies, with and without the use of injec- 
tions of water. On the other hand I have had cases where 
those remedies were of no avail, where meteorism, pain and 
anguish became excessive, and where it was absolutely neces- 
sary to use other means in order to remove the danger of en- 
teritis. In such cases I have likewise seen admirable effects 
from the oil of Ricinus, which, by lubricating the interior of 


the bowels, facilitates the discharge of excrements of stony 
hardness. The remaining disposition to obstructions of the 
intestinal canal is most certainly removed by specific remedies. 
I am willing to admit that the time will come when we shall 
be able to treat all such cases by specific remedies.; but, until 
such remedies are known, we must use the means in our 
power to the best of our ability. 

Worms in the intestinal canal are frequently looked upon 
as morbific causes, though in reality they are the product of 
some abnormal condition. There is a kind of true helminthi- 
asis where innumerable quantities of worms are formed in 
the intestinal canal, together with their nests, viz., accumula- 
tions of mucus. Atrophied children, with enlarged bellies, are 
most commonly subject to that disease. It is the consequence, 
not the cause of the atrophy, and it is extremely probable that 
the worms do not live on the chyme, but on mucus, and that 
they are therefore less injurious to the organism than has been 
supposed. It is not true that worms can corrode the bowels. 
They are not provided with organs necessary to that process. 
The perforations which have been discovered, were in conse- 
quence of softening, of a depression of vital action. It is true, 
however, that worms may occasion many disagreeable symp- 
toms, particularly if they get into the stomach or oesophagus. 
Catharucs do not cure the disease ; they simply remove part of 
its product. I do not feel disposed, however, to pronounce an 
unqualified condemnation on the method of first removing the 
worms and then strengthening the vitality of the intestinal 
canal. This can sometimes be done without injury, if the 
patients be not too feeble. Years of experience, however, have 
convinced me, that worm-affections can be cured in the safest 
manner and shortest time, by acting upon the intestinal canal 
with specific remedies, in conjunction with a rigorous, appro- 
priate diet. It is a remarkable fact, that under the operation 
of specific remedies the worm-symptoms gradually disappear, 
and that, if worms be present, these likewise ultimately make 
their exit. Would that this fact were believed by those who 
derive all gastric symptoms from worms ; who first use cathar- 
tics to expel those pretended parasites, and, if no worms be 
passed, debilitate the poor patients by the whole catalogue of 
drastic medicines. More men have undoubtedly been ruined 
by the so-called heroic treatment for taenia than have been 
freed from it. It is unfortunately too little known that the 
troublesome symptoms which indicate the presence of taenia, 
can be removed without the use of drastic medicines. 


Section 83. 

There are other material noxse, which, although they are 
products of disease, yet have to he removed from the organism 
which is disturbed by their presence. I will only mention 
closed abscesses, which have to be opened lest they should 
create and maintain pain and fever ; accumulations of water 
in cavities, the pressure of which has a paralyzing effect, and 
impedes the progress of the general treatment ; extravasations 
of blood in cavities or in the cellular tissue, which might be 
productive of evil consequences if a slow process of absorption 
were relied upon for their removal ; remaining portions of the 
placenta, stones in the bladder, and other concretions. Sir 
Jistley Cooper has cured a man who was without conscious- 
ness for thirteen months, by removing a piece of bone which 
pressed upon the brain. 

Section 84. 

The second therapeutic rule is : Remove the abnormal 
dynamic conditions. 

Disease results from some dynamic irregularity, which has 
to be neutralized by a counteracting influence. If there be too 
much expansion, we wish to induce contraction ; we endeavor 
to diminish an excess of sensibility or irritability ; in a case of 
hypertrophy we endeavor to depress the reproductive action, 
etc. The object of treatment with the partisans of every school 
and system, is to neutralize a morbid action by establishing a 
contrary influence. They simply differ in regard to the best 
mode of accomplishing the intended result. What has been 
said in former paragraphs of primary and secondary action, of 
reaction and counteraction, is likewise applicable to the opera- 
tions of medicine. Primary and secondary action refers to the 
medicine, reaction and counteraction to the oiganism. Primary 
effects have ever been more imposing to superficial observers ; 
the principle " contraria contrariis sananda " has been adopted 
by them as the chief maxim of treatment. We know from 
experience, that — 

1. The organism must be sufficiently excited for the pri- 
mary reaction to overcome the morbific cause ; and that 

2. It is necessary to insure a sufficient duration to the pri- 
mary reaction, to prevent the secondary action, which is in 
opposition to the therapeutic end. To effect such a purpose, 
large doses had to be frequently repeated. 

These rules have been followed for three thousand years, 


sometimes with great success. This must be admitted. On 
the other hand, it ought to be admitted by the most zealous ad- 
vocates of the Galenian method of cure, that many of the most 
distinguished and learned physicians of the Old (School have 
complained of the uncertainties of the ordinary treatment, and 
have expressed a desire to see the healing art constructed upon 
a safer basis. I will here briefly allude to the causes which 
make the Galenian treatment of disease unsafe and even dan- 

1. The difficulty of discovering, in every case, the proxi- 
mate cause of the disease ; this difficulty cannot be denied by 
any body. 

2. The impossibility to determine, in every case, what oppo- 
site will restore the equilibrium. 

3. The necessity to employ, in every case, powerful doses 
of the drug, which may result in many injurious consequen- 
ces, viz. : 

(a) Positive injuries inflicted upon the patient by an impro- 
perly selected drug. 

(b) Too powerful reaction of the organism, which may not 
only destroy the temporary good resulting from the action of 
a properly selected medicine, but may even aggravate the dis- 
ease. Hence it is that a number of patients have to continue 
the use of medicine uninterruptedly, lest the primary action 
should cease, and have to take the medicine in increasing doses 
on account of the irritability of the organism diminishing in 
proportion as it gets used to the action of the drug. 

(c) Disagreeable concomitant effects of a number of power- 
ful drugs, complicating the disease and embarrassing the phy- 
sician's mind by artificial symptoms. Medicines have to be 
counteracted by medicines ; a warfare has to be instituted 
against one's own weapons. 

The insufficiency of the method "per contraria" required 
the addition of adjuvantia, to act upon single dangerous symp- 
toms ; and of derivantia, the object of which is to transfer the 
affection from higher to lower organs. If, under the combined 
fire of these batteries, life become extinct together with the 
disease, nothing is left us except the poor consolation that a 
number of strong medicines have been used in the treatment 
of the case. A number of the pernicious effects of drugs have 
been mentioned in previous paragraphs. A few more instances 
of murderous treatment may be added in this place. For a 
slight attack of traumatic tetanus, Dehane ordered a decoction 
of half a pound of Peruvian bark with one hundred drops of 
the tincture of Opium, to be taken an ounce every two hours, 


together with one drachm of Quinine and the same quantity 
of the carbonate of Ammonia ; and, upon the symptoms be- 
coming more alarming, he prescribed in the course of a clay 
one pound of the carbonate of iron with theriacum, fric- 
tions of opium on the extremities, and Oleum Ricini to keep the 
bowels open. In a case of chorea, Hutchinson prescribed six 
grains of calomel every three hours, and the same quantity of 
the extract of Colocynth ; afterwards six drachms of the car- 
bonate of iron every four hours ; then an ounce of the same 
drug every three hours, together with one-eighth of a grain of 
Morphium with the essence of turpentine. From the 2d of 
July to the 12th of August, eleven pounds and seven ounces 
of iron were consumed by that patient. In the case of a man 
who was suffering with ophthalmia, and had been treated with 
large doses of tartar emetic, Stokes observed, it is true, a dimi- 
nution of the respiratory difficulties : but, on the other hand, 
vomiting and singultus set in, which continued until death. 
On instituting a post-mortem examination, the cardia was 
found inflamed. Berndt saw symptoms of poisoning arise 
from the endermatic use of the acetate of Morphia in whoop- 
ing-cough. He cautions at the same time against the general 
use of blisters of Cantharides, particularly in inflammations of 
the digestive organs, where they are too irritating and aggra- 
vate the disease. Weisse mentions a case of diabetes caused 
by a blister of Cantharides. In delirium tremens, iSpence gives 
thirty grains, say thirty grains ! ! of tartar emetic every half 
hour. In a case of tetanus, Lisfranc ordered eight venesec- 
tions, at the rate of one pound of blood at a time ; then eight 
hundred leeches to be applied, and large doses of Opium to be 
given besides. To destroy aneurisms by anastomosis, Ollivier 
has proposed to inoculate the parts with the poison of the hos- 
pital-gangrene. Hamilton inflicted the following treatment 
upon a girl of sixteen years, who, for some weeks past, had 
shown symptoms of febris continua, spoke incoherently, and, 
for the last four days, had frequently uttered loud cries on ac- 
count of great sensitiveness of the abdomen : 

Dec. 29 : Venesection of twelve ounces, warm fomentations 
on the abdomen, injections of salts and Senna, and a grain of 
Opium internally, every four hours. 

Dec. 30 : No change; venesection of eight ounces. Leeches 
and warm fomentations, injection and a grain of Opium inter- 
nally, every hour. 

Dec. 31 : No stool. Owing to constant drowsiness, only 
two pills of Opium could be given. Sopor, momentary open- 
ing of the eyes when spoken to, and relapse into the former 



condition. The patient ceased to complain. Three drops of 
Croton-oil were now ordered. The sopor had increased to- 
wards evening, all sensibility had disappeared, deglutition be- 
came difficult, pulse feeble and one hundred and forty. The 
patient was given a little teacupful of wine and water every 
minute. Death ensued on the day following, at five o'clock in 
the morning. 

This case of homicidal treatment would have been better 
adapted to a vade mecum satyricum than to the " Collection 
of Select Cases"* a title which can only be degraded by such 
cases. In the Dublin hospital, every new-born infant is given 
a grain of calomel four or five hours after birth, and, eight or 
ten hours afterwards, a few doses of Oleum Ricini, to carry off 
the meconium. Feroni (see his Annals, Vol. III.) has shown, 
by a number of warning cases, with what pernicious results 
the obstinate carrying out of preconceived opinions may be 
attended in the treatment of disease. I do not wish to extend 
this list of commissions to a greater length. Volumes might 
be filled with the records of shameful and criminal treatment. 
The few cases which I have communicated above, will prove 
sufficient to cause all honorable and independent physicians to 
mistrust the old-fashioned boasted Medicina Rationalis, and to 
examine the specific or homoeopathic method of treatment with 
an earnest and becoming attention. 

Section 85. 

Nature, the great teacher, shows us the way to cure dis- 
eases without the use of cruel and dangerous drugs. The dif- 
ficulty lies in properly observing and understanding Nature's 
teachings. What takes place when two different diseases meet 
in the same individual, is particularly instructive. 

Dissimilar diseases may, under certain circumstances, co- 
exist in the same individual, particularly when the dissimila- 
rity is very great, when different parts of the organism are the 
seat of the disease, and when the affected organs have nei- 
ther sympathetic nor antagonistic relations with each other. 
Itch-patients may be attacked with dropsy or syphilis ; hys- 
teric or epileptic patients may be attacked by any kind of in- 
flammatory disease. Frequently, however, the complication 
is only apparent ; for the disease which is supposed to have 
supervened, may be a continuation, a material development or 
dynamic transformation of the original affection. In this way, 

* Vol. XVII., p. 716. 


encephalitis or meningitis may pass into hydrocephalus, hepa- 
titis may change to ascites, typhus-fever may terminate in 
apoplexy, and inflammatory diseases frequently assume a 
typhoid form in consequence of the fashionable depletions. 
We hear frequently, that this or that patient might have been 
saved if typhus-fever or apoplexy had not supervened ; men- 
tion is frequently made of three or four diseases as having 
supervened, whereas they are mere developments of one and 
the same abnormal vital process, which, unfortunately, are but 
too frequently the result of improper treatment. 

Generally speaking, diseases, even when dissimilar, cannot 
coexist fully developed in the same organism, if tissues or or- 
gans which have sympathetic relations with each other are the 
focus of the morbid process. This is the reason why one dis- 
ease protects one against another. Scurvy guards one against 
the oriental plague. Pittschaft relates, upon the authority of 
the traveller Azabas, that in Paraguay the bites of venomous 
serpents are not fatal to syphilitic patients : he adds, that per- 
sons who are afflicted with gonorrhoea are not easily attacked 
with typhus. Klose accounts for these and similar facts by 
the principle of antagonism. Sometimes dissimilar diseases 
set in when some other disease is present, which is sus- 
pended in such a case until the former have run their course. 
In the year 1779, the small-pox disappeared in those districts 
where the then prevailing influenza broke out, but reappeared 
as soon as the influenza left. (See Richter's Therap., p. 273.) 
Glehii treated a patient who had small-pox and scarlatina at 
the same time. A violent fever set in, which threatened to 
run into typhus. Scarlatina then made its appearance, which 
disappeared on the day following, when the small-pox broke 
out on the patient. Epilepsy has been suspended by tinea 
capitis and flowing piles, itch by scurvy, gout by haemorrhoids, 
not to mention other numerous observations. It is assumed 
that the weaker disease is always overpowered by the stronger. 
This cannot be denied. But the intensity of a disease cannot 
be measured by its generic character. All depends upon the 
individual character of the conflicting diseases, which is evi- 
dent from the fact that simultaneously existing diseases fre- 
quently alternate. If either of them were stronger in an abso- 
lute sense, it would never yield to the other. On the other 
hand, it is impossible to explain why dissimilar diseases co- 
exist in one, and suspend each other in another individual ; 
the reason, perhaps, is, that single systems and organs some- 
times maintain a certain relative independence, and are little 
or not at all involved in the general disturbance of the organ- 


ism, and that at other times and in other individuals such 
systems and organs are extremely sympathetic. 

The case is different with diseases that are similar; if 
similar diseases coexist in the same individual, the weaker is 
completely effaced by the stronger. Opponents of the specific 
healing art have taken great pains to quote instances of co- 
existing similar diseases, such as measles and small-pox, va- 
rioloid and variola. As to the similarity of measles and 
small-pox, it may boldly be asserted that there is not any ; 
that similarity is confined to the presence of an acute exan- 
them breaking out with febrile symptoms, but differing in the 
two diseases in form as well as in regard to the concomitant 
symptoms. The measles are seated in the epidermis, the 
small-pox in the rete Malpighianum, and, according to Sacco, 
in the corium ; this latter opinion is likewise entertained by 
me. Moreover, it has been observed by ancient and modern 
physicians, that the two diseases run a different course ; one 
remains latent until the other is on the decline. This is like- 
wise the case with variola and varioloid, with this important 
difference, that the disease which breaks out first, attains its 
complete development, and that the other eruption, which 
appears later, is evidently modified ; showing that the more 
powerful disease had very nearly succeeded in effacing the 

Hahnemann has collected a number of cases, showing 
that the weaker disease is effaced by the stronger. In many 
of those cases, the external similarity is not very remarkable. 
If small-pox is sometimes accompanied or succeeded by a 
swelling of the arm, swelling of the testicles, dysenteric diar- 
rhoea, ophthalmia, and blindness, it does not follow that there 
is a similarity between these diseases and small-pox. There 
are other, much more instructive and convincing cases, such as 
habitual headache disappearing in consequence of a typhus 
characterized by a similar affection of the head, or paralysis 
of the arm as a sequel of typhus, disappearing again after the 
lapse of several years under the influence of a second attack 
of typhus. Three years ago, I vaccinated a child that had 
been several times attacked with erysipelas fugax ; the last 
attack having taken place eight days previous. The inflam- 
matory redness showed itself on 'the ninth day, spreading 
from the spot where the vaccine had been applied upwards 
and downwards, to the shoulders and tips of the fingers. 
Both arms swelled to an enormous size, and the fever was 
very violent. When this inflammation had dispersed, the 


disposition to erysipelas, which was a similar inflammation, 
had entirely disappeared. 

The attention with which I have for some years past 
investigated this subject, enables me to say, that only such 
diseases have power to efface each other, as are not only simi- 
lar in regard to their dynamic character, but are seated in the 
same systems and organs. If this observation be correct, it 
furnishes an additional proof of the necessity to study the 
dynamic character of the disease we are called upon to treat, 
and the anatomical region, which is the seat of the disease. 

Section 86. 

Although observations such as have been recorded in the 
preceding paragraph, naturally point to the principle " similia 
similibus curanda ;" nevertheless, the firmest support of that 
principle, is experience at the bed-side of the patient. It can 
be shown from history, that that principle has been followed 
in practice from time immemorial, in a vast number of cases. 
Hahnemann, and his disciples, have compiled a multitude of 
cases where the homoeopathic law has led to successful and 
brilliant results in practice. I will here record a few facts 
confirmatory of my statement. 

Belladonna, which produces in the healthy organism a 
group of symptoms very similar to hydrophobia, has been 
known, for a long time past, as one of the principal remedies 
for that disease. 

Mercury, with which we cure syphilis, occasions ulcers 
which resemble syphilitic ulcers so closely that these two 
kinds of ulcers are frequently confounded with each other. 

The oil of turpentine, which is a distinguished remedy 
for burns, occasions a painful burning on the skin. It may not 
be out of place here to observe, that I have found sulphuric 
acid, the caustic properties of which are far superior to those 
of turpentine, much more efficacious in burns than the latter 
substance. Lately, a solution of phosphorus in oil has been 
recommended as an application to burns, upon the same prin- 
ciple as turpentine and sulphuric acid. 

Stramonium removes insanity, which it causes in healthy 

Millefolium, has frequently been employed with success 
against certain kinds of haemorrhage ; it possesses the pro- 
perty of exciting haemorrhage in the healthy. 

Dulcamara, a well-known remedy for herpetic eruptions, 


has, according to Carrere's observations, occasioned similar 
eruptions over the whole body. 

Sulphur, with which a number of eruptive diseases are 
cured, possesses the property to occasion eruptions. Some 
have attempted to deny this. Any one who wishes to be- 
come convinced of that fact, needs but to travel to some sul- 
phur springs, where he will find the largest number of the 
guests covered with the so-called " bath-rash."* Let me re- 
mind my readers of Krimefs observations, that sulphur-baths 
frequently cause the very thing which they are intended to 
cure. Bird (in Rust's Magazine, vol. 38), relates a case of 
ophthalmia occasioned by sulphur ; we know that sulphur is 
an invaluable remedy in many inflammations of the eye. 

Tea occasions palpitation of the heart, anguish, and rest- 
lessness, particularly in persons who are not accustomed to its 
use. Kremers has seen intoxication produced by the exces- 
sive use of tea. In the hospital of London, a case of poison- 
ing by Opium has been cured with green tea, and we know 
that tea acts very beneficently in intoxication. (See Lancet, 
November, 1833.) 

Colocynth causes dysentery with colic. Ehrenberg and 
Hemprich relate that the Arabians employ camel's milk which 
has been left standing over night in a hollow colocynth, as a 
preventive against dysentery. Leo Wolf, of New- York, has 
successfully treated dysentery with Colocynth. 

Cantharides occasion a violent irritation of the intestinal 
mucous membrane with diarrhoea. A woman who had been 
for some time past treated for chronic diarrhoea without benefit, 
took pills of Cantharides, and was completely cured within a 

Opium has frequently been employed with great success 
for incarcerated hernia and ileus. 

I refrain from quoting homoeopathic physicians as authori- 
ties. There is a disposition to doubt any statement that ho- 
moeopathic physicians may make, and even to accuse these 
gentlemen of wilful deception. He who possesses sufficient 
independence of mind not to allow himself to be predisposed 
against the new doctrine by mere invectives, and to examine 
it with impartiality and attention, will soon become convinced 
that the principle " similia si??iilibus sananda" is brilliantly 
confirmed by experience. 

* This is the literal translation of the German term for that eruption. 

organon.of the specific healing art. j51 

Section 87. 

Select a remedy which is capable of producing in the 
healthy organism an affection similar to the disease which is 
to be cured. 

We have not, as yet, succeeded in establishing the homoeo- 
pathic law by a demonstration a priori ; such demonstrations 
are impossible, both as regards the homoeopathic or any other 
law of cure. The maxims of cure are all derived from 
experience. If we find, upon analyzing the curative pro- 
cess, that the facts agree with other well-known laws of Na- 
ture, the principle of cure upon which our treatment was based, 
attains a higher scientific character. Hahnemann has pro- 
claimed the homoeopathic law as an empirical truth, enjoining 
upon his followers to adopt it without caring about the ration- 
ale of its operation. If he had taught an hypothesis, and, by 
a series of syllogisms, had constructed a system of cure with- 
out the slightest practical value, he would have been much 
more acceptable to rigorous dogmatists, than by his simply dis- 
covered, but not invented law. Several learned authors 
have attempted, with more or less success, to explain the 
modus operandi of a homoeopathic agent upon the principle of 
polarity, although it is impossible to bring every little occur- 
rence in Nature under such a vast generalization as the prin- 
ciple of polarity, which is founded in reason, though not as yet 
susceptible of universal demonstration. The contemplative 
study of nature sometimes enables us to infer a principle from 
single phenomena, which, owing to our ignorance of the inter- 
mediate links, we should not have been able to develope from 
a superior generalization, with which the former principle may 
nevertheless agree. This principle becomes an empirical truth 
when we see it confirmed in numerous cases. Analysis and 
combination give it, of course, a higher value. 

We have shown above that the living organism possesses 
the power to oppose and neutralize noxious influences. If the 
noxious influence be more powerful than the vital force, the 
organism experiences a series of morbid sensations which con- 
tinue as long as the morbid influence prevails with its original 
force. Hence it is that diseases which are not the product of 
some contagium, that is unchangeable, and, after having in- 
vaded the organism, consumes itself, never get well by the 
unaided power of the vital force. But if the morbific influence 
have been weakened, the vital force then endeavors to react 
and very often does successfully react against the former by 


establishing a state which is ia polaric opposition to the former 
state of disease. In this way the organism cures itself. 
While this spontaneous reaction is going on, it is important not 
to interfere with artificial means. John and Halford have 
offered some interesting observations on that subject. If no 
improvement take place, the vital force is too feeble to realize 
a curative reaction. In that case art has to interfere with ap- 
propriate means to stimulate the reactive force of the organ- 
ism, and to enable it to free itself from disease. 

Section 88. 

In the following paragraph I shall examine some of the 
principal objections which have been raised against the ho- 
moeopathic law as a principle. 

1. If the living organism possess the power to realize a 
state which is opposed to a state of disease, why does not a 
cure take place spontaneously 1 

It is evident that the disease must continue as long as the 
morbific influence is not removed. But if, after its removal, 
disease continue, it ceases to be a mere reaction against some 
external noxious influence ; the vital force itself is diseased, 
and is therefore unable to react against its own abnormal con- 
dition. Organs which are less diseased, may react against the 
abnormal functions of other organs ; this gives rise to a com- 
motion of the organism, during which the parts that were first 
invaded, frequently are the most quiet, and gain time to recruit 
themselves. In this way a cure frequently takes place spon- 
taneously in consequence of some critical revolution. Such a 
revolution, where one organ opposes the other, is, however, a 
doubtful struggle ; it is much safer to rouse the reactive power 
of the vital force by means of an artificial opposite, which cor- 
responds to the general abnormal state. 

2. If the specific or homoeopathic curative agent excite a 
disease similar to the natural disturbance, how can this be 
cured, or must it not rather be made worse by the homoeo- 
pathic agent ? 

Some have attempted to answer that question very briefly 
by saying that the natural and the artificial diseases neutralize 
each other like positive and negative electricity. Without 
wishing to find fault with this ingenious explanation, I shall 
simply content myself with adhering to facts. It is, indeed, 
true that diseases are made worse by multiplying the num- 
ber of noxious influences. Specific remedies produce the same 
result, especially when given in a dose which is powerful 


enough to affect the organism pathogenetically. The disease 
is, indeed, sometimes aggravated by the homoeopathic agent. 
Leo Wolf, in treating dysentery with Colocynth, has observed 
in every case an aggravation of the symptoms previous to re- 
covery. Bartels recommends for chronic liver-complaint foot- 
baths with nitro-muriatic acid, which first occasion a con- 
siderable aggravation of the symptoms. Similar aggravations 
have been so frequently observed by homoeopathic physicians, 
that it has been supposed they were necessary precursors of a 
cure. Hahnemann, who, at first, used large doses, was led to 
the discovery of the attenuations by the frequently dangerous 
aggravations occasioned by such doses. It is, therefore, an 
established rule to give such doses as will suffice to excite the 
curative reaction of the organism. 

3. Counter-action is a negation of the primary action. Now, 
if the primary action be so feeble that it is scarcely perceptible, 
how is it possible that the counter-action should be powerful 
enough to extinguish the disease? 

Hahnemann answers this question briefly by stating that 
the disease, being an inferior and relative condition, is weaker 
than the medicinal agent, which possesses an absolute power 
to alter the dynamic condition of the organism. This expla- 
nation is not sufficient. It is refuted by the fact that real drug- 
diseases can be cured antidotally with small doses of other 
drugs. Nor is it sufficient to assert, that the quantity and 
quality of a homoeopathic agent are in an inverse proportion, 
and that the power of the drug increases in proportion as it is 
more highly attenuated. This is contrary to experience. We 
attenuate medicines to diminish their excessive action. Ex- 
perience will tell us why the homoeopathic agent, though 
small, is still powerful enough to effect a cure. We know from 
experience that the dynamically disturbed organism is most pow- 
erfully affected by influences which have a tendency to realize 
a similar disturbance in the healthy organism. Such influen- 
ces might be called homogeneous. The susceptibility to hete- 
rogeneous influences is diminished in a proportionate ratio. 
This is the reason why contrary agents have to be used in 
large quantities, whereas the smallest portion of a similarly 
acting or homogeneous agent is sufficient to secure a powerful 
reaction. The sentient nerve, if affected in a certain direction, 
is inclined to be again affected in that direction ; even a feeble 
sound is capable of eliciting vibrations from a correspondingly 
attuned string, and the slightest impression is sufficient to 
increase the speed of a rolling ball. An irritated temper may be 
vehemently excited by the slightest contradiction, and the most 


inveterate drinker may become intoxicated by a glass of wine 
which he swallows in a fit of passion. The homoeopathic 
agent acts as certainly as the chemical bodies which, by their 
mere presence, disturb the relations of affinity. If a man be 
half intoxicated with wine, a few glasses of ram will stupefy 
him entirely, whereas a teaspoonful would dispel the diz- 

As regards the modus operandi of remedial agents, it is 
beyond our power to account for it. 

Section 89. 

In homoeopathic treatment we require to exhibit agents, 
the effects of which upon the healthy organism are as simi- 
lar as possible to the disease. 

It is important to know, by what means that similarity 
shall be determined. Hahnemann's plan is, to compare the 
symptoms of the disease with those of the drug, and to give 
the medicine which has the largest number of similar symp- 

This peculiar method of selecting a remedy by the symp- 
toms, has been assailed with great vehemence by the partisans 
of the old dogmatism in Medicine. I shall not waste my 
time to show that, if all the symptoms have disappeared, the 
disease must have ceased likewise. I am also willing to 
admit, that the proposed symptomatic treatment is, in an im- 
mense number of cases, sufficient to cure the disease ; but 
there are likewise cases where such a thing is impossible, 
from various reasons. 

1. There are diseases where only a few, or, perhaps, a 
single symptom, are perceptible to the senses, and where it is, 
of course, impossible to select the proper remedy, unless we 
have a correct knowledge of the general dynamic condition of 
the organism. Let us take a case of simple prosopalgia with- 
out any characteristic symptoms. It has to be treated dif- 
ferently according as it arises from this or that cause. If 
arising from a cold, we may have to employ Aconite, Nux 
vomica, or Hepar sulphuris ; if it have appeared after an at- 
tack of fever and ague, we may have to give China, or Ar- 
senic ; if it be caused by Mercury, Aurum or Hep. sulph. 
may be the true remedy. Hahnemann's rule is, to give a 
remedy which seems to be most similar to the symptoms ; if 
then new symptoms arise, he advises to take another record, 
and make a new selection ; this method is to be continued 
until every symptom has disappeared. The same method is 


to be pursued in the treatment of local affections, though these 
generally reflect some general internal affection, the removal 
of which, by appropriate specifics, will undoubtedly be fol- 
lowed by the disappearance of the local complaint. This is 
Hahnemann's own opinion, to which 1 willingly agree. Many 
an operation is avoided by treating ulcers, excrescences, tu- 
mors, tubercles, etc., homceopathically. In the last eight years, 
I have had twice the pleasure of saving carious limbs, which 
had been condemned by the doctors ; the ulcers healed, and 
the patients were able to return to their occupations. Of 
course, we ought not to go too far in opposing surgical opera- 
tions. Why should we not open an abscess, apply a cata- 
plasm, change a fistula to a readily healing open wound, 
exsect a cancer of the lip, or put a ligature round a polypus, if 
we know that the patient will be relieved by the operation 1 
The local treatment may frequently be sufficient. This, 
however, is not the place to say when and where the local 
and general treatment should go hand in hand, or remain 


Section 90. 

Another difficulty in treating diseases by the mere symp- 
toms, is 

2. The prominent development of sympathetic affections. 
Werber observes, that we must employ remedies which will 
act upon the diseased organ and attack the very focus of the 
disease. Suppose the original symptoms of the disease are 
very obscure and the sympathetic symptoms very prominent, 
how shall we succeed in at once selecting the true curative 
agent, if we suffer ourselves to be exclusively guided by the 
symptoms'? Why should we not avail ourselves of every 
means in our power, to obtain a correct knowledge of the 
pathological character of the disease and the relative value of 
the existing symptoms ? In fevers, particularly, it is of the 
utmost importance to investigate the focus of the disease, since 
fevers are, as a general rule, reactions of the vascular system 
against some abnormal local change which has to be removed 
if we wish to cure the fever. We have some excellent reme- 
dies which are specifically adapted to the cure of fevers, such 
as China, Quinine, Arsenic. But even these specifics only cure 
the fever, if the internal cause of the disease be removed under 
their influence. If the internal local affection continue, the 
fever will either break out again, or else the morbid action 
will be transferred to some other sympathetic organ. In this 


way it is that febris larvata, intermittent neuralgia, infarctions 
of the liver, dropsy, etc., are brought on, and we then may con- 
gratulate ourselves if these dangerous and distressing vica- 
rious affections give place again to the original disease. 

Beside fevers, there are many other affections originating 
in sympathy. Headaches, for instance. A glance at the 
Materia Medica will convince us of that fact. Headache is 
scarcely ever wanting, and yet, it would be foolish to suppose 
that headache is always a primary symptom. A sympathetic 
headache is frequently very intense, and yet, nothing needs 
to be done for it directly, it will disappear of itself, together 
with the pain or disorder upon which it depends. 

Section 91. 

In treating a disease symptomatically, we frequently come 
3. In collision with the curative efforts of nature. Many 
symptoms occur which are indications of a favorable spontane- 
ous reaction of the vital force, and should not be disturbed. It is 
true such mistakes can only happen to the inexperienced ob- 
server. A critical diarrhosa, setting in after an indigestion with 
constipation, should be allowed to run its course ; or a critical 
sweat in pneumonia should be left undisturbed. To treat 
disease, we have to know something more than the symptoms, 
we have to be acquainted with the pathology, course, and criti- 
cal changes of diseases. Alas, too many think themselves 
competent physicians, whose only claims rest upon the pos- 
session of a medicine-chest, and a repertory of the Materia 

Section 92. 

The curative efforts of Nature ought to be assisted, not 

The counter-action of the organism is either entirely want- 
ing, or it is too feeble or too violent, or, lastly, it is adapted to 
the purpose of cure. In each of these cases particular rules 
have to be observed. We will examine them singly. 

1. If the counter-action be entirely wanting, the symptoms 
undergo no change, except so far as the disease progresses in 
its course. In this case, the symptoms either denote 

a. Debility, as in adynamic, putrid fevers, cachexia?, etc. 
In such conditions of the organism, so-called corroborants 
and stimulants have frequently been of great use. A more 
nourishing diet, a good soup, a glass of wine, an aromatic bath, 
and similar means which rouse the energy of the general or- 


ganism without acting specifically upon the affected tissue, are 
frequently sufficient to excite a beneficent reaction in the or- 
ganism. A female who was nearly dying with an adynamic 
fever, was cured by Rademacher, with eight ounces of alcohol, 
and one ounce of sulphuric ether, which she had to take in one 
night, little by little. Delonnes cured an aged woman who 
had been brought to the brink of the grave by venesections, 
cathartics, and emetics, by giving her large portions of a strong 
Spanish wine, and applying hot napkins to her body. Hux- 
ha?n : Pringle, and Whytt, have recommended wine under simi- 
lar circumstances. Berends relates the case of a scrofulous 
boy who was attacked with small-pox. The case went on 
favorably until the second day, when the boy became suddenly 
stupid, with dilatation of the pupils, insensibility to light, 
slow and feeble pulse. The boy was stimulated with broth 
and malaga, the exanthem became efflorescent, and the dis- 
ease terminated favorably. 

Our coarse domestic practice has a number of such cases 
to exhibit. On the other hand the indiscreet use of stimulants 
frequently results fatally. This is owing to the fact that cer- 
tain symptoms of weakness are mistaken for indications of a 
general debility of the organism, whereas the weakness results 
from the arrest or limitation of the peripheral activity of the or- 
ganism, in consequence of the disease of some central organ. 
If the fainting turns and the small trembling pulse were to 
induce us to give wine and other stimulants, we would simply 
hasten the death of the patient. Stimulants can only be given 
when we are sure that there is no general prostration of the 
vital forces. Even the homoeopathic physician is, under these 
circumstances, bound to prescribe a nourishing diet, broth, 
eggs, or a little wine ; these things may even prove sufficient 
without giving any medicine. The case is different when 

b. The peripheral vital action is exhausted, and a tumultu- 
ous reaction takes place in an organic system ; that tumult 
would be increased by stimulants. The intensity of the reac- 
tion shows that the organism has sufficient power to react ; 
and if the curative counter-action do not set in, we have to 
infer that the morbific cause, whether internal or external, still 
continues. In that case we have first to discover the cause, 
and then to remove it by suitable specifics. 

2. When the counter-action is too feeble, we observe symp- 
toms of an uncertain struggle between the organism and the 
morbific agent, a wavering of the organism between restora- 
tion and depression, and primary phenomena of disease with 
symptoms of counter-action, the former remaining, however, 


superior. The selection of the remedies must be made in con- 
formity with those primary phenomena. Suppose we have a 
case of acute rheumatism to treat, the patient has violent fever, 
with a burning skin and diminution of all the secretions ; he 
suffers with violent pains in the limbs. The curative efforts 
of nature are manifested by a transitory discharge of blood from 
the nose, increased secretion of urine and sweat, the pains are 
somewhat relieved while those critical secretions last. These, 
however, are not permanent ; an exacerbation of the symptoms 
takes place as soon as the secretions stop. According to the 
rules of the old school, it is important to observe the mode and 
character of the critical changes which the organism endeavors 
to accomplish. If there be a disposition to critical changes by 
the bowels, a cathartic is given, if the organism show a dispo- 
sition to perspiration, diaphoretics are prescribed, very fre- 
quently with excellent effect. Many would laugh in our faces 
if we were to undertake to show that elder-tea, which they 
have so frequently and so successfully employed for a rheu- 
matic fever, leaves a dangerous train of after-symptoms. In 
short-lasting acute diseases such symptoms need not to be 
dreaded. Provided the disease has reached a successful crisis, 
the drug symptoms, if there be any, disappear very speedily. 

To assist the organism in its efforts to free itself from dis- 
ease, by artificially producing the critical changes indicated by 
the organism, does not seem such a very irrational proceeding. 
But physicians have gone too far in that direction ; they have 
attempted to control instead of assisting nature. Some under- 
take to expel all diseases by sweat, others by the bowels, and 
nature, poor nature, which, if left alone, might perhaps suc- 
ceed in restoring itself, is compelled to curb itself under the 
yoke of a blind and foolish sophist. In this way the cure of 
innumerable diseases has been retarded, and the sufferings 
of the patient have been aggravated and often rendered in- 

In treating disease homceopathically, all that is required is 
to give a remedy which shall correspond as perfectly as possi- 
ble to the general morbid condition, and nature is left free to 
establish a counter-action in whatever direction she pleases. 
Any body who practises the specific method of cure with dis- 
cretion, knows that it is by far the safest, and never inflicts any 
positive injury. Sometimes, however, 

3. The counter-action is too violent, either in the primarily 
invaded, or in the sympathetically affected organs. In such 
cases the vital force has obtained an absolute control over the 
morbific agent. We see, for instance, that a diarrhoea is fre- 


qUently followed by an obstinate or chronic constipation, a 
metrorrhcea by a suppression of the menses, an inflammatory 
swelling by atrophy of the affected parts ; emaciation by a ten- 
dency to get fat. These are polaric inversions, which, if they 
last beyond the proper time, have to be treated as morbid condi- 
tions, with great care, however, lest too powerfully-acting doses 
should again lead to the opposite extreme. Medicines, the 
primary effect of which, is antipathic to the existing disease^ 
are the most dangerous to be used in equilibrating such alter- 
nate conditions. Patients who are treated with such means, 
remain for ever after in the hands of the physician and apothe- 
cary. The secondary effect of one drug has to be neutralized 
by the primary action of another, which again leaves a secon- 
dary effect, and so on, until the patient is either ruined or gets 
tired of the butchery, and prefers relying upon Nature's own 
powers. If specific remedies should occasion secondary effects, 
they ean easily be removed. 

4. The so-called alternate effects are, properly speaking, a 
wavering between primary and secondary effects. A similar 
state is frequently observed even without medicine, where, at 
times, the morbific agent, at others the counter-acting organism 
prevails. The alternation of chilliness and heat in fevers 
might, perhaps, be classed in the category of alternate effects. 
Contractions and expansions, fluent coryza and obstruction of 
the nose, diarrhoea and costiveness alternate with each other. 
As a general rule, the counter-exertions of the organism are, in 
such cases, too feeble to restore the equilibrium of its forces, 
and if such fluctuating phenomena result from the action of 
the remedy, it ought to be given in a larger dose, or more fre- 
quently. Sometimes, however, this alternation from one state 
to the opposite, arises from the fact that the medicine, instead 
of acting upon the focus of the disease, acts upon a sympa- 
thetic organ, occasioning incomplete reactions, and requiring 
the exhibition of some other drug. 

5. The counter-action of the organism may be sufficiently 
powerful to effect the restoration of health. It is then that the 
greatest sins are frequently committed by the attending physi- 
cian. He does not want the patient to suppose that medicine 
has been of no use. To show his importance, the physician 
prescribes all sorts of medicines which he pretends will assist 
Nature, whereas his meddlesome interference disturbs, and 
frequently arrests the reactive efforts of the organism. Ho- 
moeopathic medicines are likewise prejudicial if used under 
such circumstances. There are, however, patients who ima- 
gine that nothing is done for them, if they do not take 


medicine. In that case some indifferent substance may be 

Section 93. 

By keeping in view the remarks which have been offered 
in the preceding paragraphs, the principle " similia similibus 
curanda" will not be misunderstood. A remedy ought to be 
chosen, not because it is capable of producing symptoms which 
are similar to those of the disease, but because the general state 
of the organism arising from the action of the drug is similar 
to the general character of the disease. Skill and experience 
are required to practise medicine rationally. It is a remarka- 
ble fact, however, that physicians with the dullest comprehen- 
sion are sometimes the most successful practitioners. They 
do not trouble themselves with doubts, and content themselves 
with treating disease according to the rules of the school, no 
matter what may be the result. Physicians with a higher 
intelligence frequently complain of the incompleteness of medi- 
cal science and the uncertainties of diagnosis. The mere name 
of the disease, and the place which the disease occupies in no- 
sological systems, do not enlighten us about the treatment. We 
require to have a clear perception of the dynamic character of 
the disease, in order that the general as well as special symp- 
toms may be properly understood in their true character as 
curative indications. Frequently, however, we are at a loss to 
unravel the pathological character of the disease ; etiology, 
symptomatology, and semiotic, leave us in the lurch. What 
is to be done in such a case? 

The best course, under those circumstances, is to select a 
remedy in accordance with the totality of the symptoms, as 
nearly as possible. The greater the danger the more marked 
are the symptoms, and the easier it will be to select a remedy. 
Symptoms are certainly more important than they at first sight 
appear. We have not yet sufficiently studied the true meaning 
of the symptoms of our drugs, to derive any knowledge from 
them relative to the dynamic and polaric relations existing 
between single organs, still less, relative to the retroactive influ- 
ence of sympathetic affections upon the whole organism. Many 
symptoms appear to us accidental, which are nevertheless of 
the highest importance in practice. I beg leave to corroborate 
this statement by a few cases from my own practice. 

Some time ago, I was asked by a young lady to give her 
something for toothache. She could not tell how she got it, and 
was only able to mention the following symptoms : troublesome 


itching over the whole body, in the evening after lying down ; 
afterwards, drawing, gnawing toothache in the left upper jaw, 
disturbing sleep ; the tongue was somewhat coated white ; in 
the daytime she felt very weary and ill-humored, had dis- 
charge of water from the nose with paroxysms of violent sneez- 
ing. This was evidently a catarrhal affection, to which, con- 
sidering its general character, Sulphur and Chamomilla seemed 
to correspond more particularly. The violent sneezing, how- 
ever, decided me to give Cyclamen ; the pain never returned. 

A vigorous woman of forty-seven years, fresh complexion, 
who had been predisposed to congestion of blood, and had fre- 
quently been bled on that account, was attacked with pulmo- 
nary hemorrhage, in consequence of some physical exertion. 
More than a pint of bright-red blood was thrown up without 
cough. I was sent for immediately, but was unable to discover 
any other symptoms except a full, hard, slow pulse. There 
were no pains in the chest, the breathing was free and easy. 
Venesection was proposed, to which I objected. To quiet the 
circulation, I gave Aconite. Next day, at the same hour, the 
haemorrhage returned. The symptoms were entirely the same, 
except a pain in the right knee, which had supervened. This 
pain being characteristic of Ledum palustre, which is, more- 
over, an excellent remedy for active haemorrhage from the 
lungs, I gave it at once. The haemorrhage ceased ever after. 

Some time ago, I treated a young carpenter for ischias. 
The remedies had no effect. The father of the boy then com- 
plained to me that his son was very forgetful. This symptom 
reminded me of Staphysagria, a single dose of which removed 
the disease within four days. 

A lady disposed to obesity, of forty-eight years, was fre- 
quently attacked withf nightmare after the cessation of the 
catamenia. Supposing that it arose from a congestion of blood, 
I gave her what I thought proper to remove it, but in vain. 
Upon instituting a more careful examination, I found that she 
was frequently tormented by violent itching between the sca- 
pulae, and that a rash had made its appearance on the back. 
Two doses of the carbonate of potash, which corresponds to 
that symptom, cured her in five days completely. 

An irritable and quarrelsome female, who was pregnant for 
the fourth time, had taken it into her head that she would die 
during her next confinement. She had become quite melan- 
choly, and requested my advice by letter. She stated her 
symptoms incompletely. Aurum had no effect. Hyosciamus 
was likewise ineffectual. Afterwards I saw the patient per- 
sonally, and was then told that she frequently grated her teeth 


at night. This symptom is characteristic of Conium, which 
corresponded to the condition of my patient in all other respects. 
She got well at once. 

A hypochondriac old man had been suffering for some time 
past with gastric difficulties and diarrhoea. I found, moreover, 
that he was attacked three or four times a day with a shud- 
dering in the pit of the stomach, as if icy-cold water were 
poured over him. This symptom indicated phosphoric acid, a 
few doses of which cured him at once. 

These few cases may suffice to show the importance of a 
most accurate record of the symptoms. No one can be more 
desirous than I am, of reducing the rules of practice to a ra- 
tional system ; but, on the other hand, no one can be more 
deeply convinced of the impossibility, in the present state of 
medical knowledge, of connecting the symptoms into a logical 
unit. Our pathologists, indeed, explain every thing. It is 
easy to see that a toothache, with sneezing, has a catarrhal ori- 
gin ; but a catarrhal toothache may likewise exist without 
sneezing. And yet the sneezing, in the above mentioned case, 
was the principal curative indication. 

It may be said that the pain in the knee, in the above men- 
tioned case of haemorrhage from the lungs, indicated a rheu- 
matic affection to which Ledum corresponds. This may be, 
although the rheumatic character of the affection is rather 
counter-indicated by the fact that physical exertions were made 
with raised arms. Of the many anti-rheumatic remedies, not 
one would have effected so rapid a cure as Ledum, which cor- 
responded most nearly to all the symptoms. 

It will be just as difficult to explain the pathological con- 
nection of forgetfulness and ischias, or of a rash on the back 
with nightmare. What is the precis* dynamic character of 
rheumatic pains when the affected parts are disagreeably cold, 
and which yield so readily to Cocculus? Why does Ranun- 
culus cure the rheumatic pains of the intercostal muscles when 
attended with catarrhal symptoms, as 1 have so often observed 1 
Why does Ignatia remove gastric complaints in persons of a 
lively, good-natured disposition, and why is Nux vomica 
more adapted to persons of a vehement temperament ? There 
is an answer to these questions, but it is too general to be of 
much avail for the explanation of special conditions. My an- 
swer is based upon the view that disease originates in a dis- 
turbance of the vital dynamis. 

The symptoms of disease reflect the diseased action of the 
nervous system, taking place in the nerves themselves or in 
the organs of the reproductive and vegetable life under the con- 



trol of the nerves. We account for many phenomena by the 
progression of the disease from organ to organ, and the appear- 
ance of the disease in organs at a distance from each other, by 
the fact that nerves dip into the organic substance, and that 
they anastomose with each other. The pathology of the ner- 
vous system has been too much neglected. We have devoted 
our attention almost exclusively to the study of the material 
differences prevailing among the organs which are subject to 
the control of the nerves ; whereas the most important and 
most interesting point would seem to be, to investigate the laws 
upon which all nervous action, this source of our sensations 
and regulator of the organic functions, depends. The theory 
of the specific healing art must, above all, rest upon adynamic 
ground. For the homoeopathic physician, the pathology of the 
nerves is a subject of vital and paramount interest. " He is 
bound to believe that his remedies affect, in the first place, the 
sensitive sphere, and, by its means, extend their influence over 
the other tissues and organs. We are entitled to judge of the 
dynamic relations of the organism by the perceptible symp- 
toms, and to prescribe in accordance with the symptoms, when 
certainty and conviction are wanting. Hence it is of the 
utmost importance to institute the most careful comparison be- 
tween the symptoms of the drug and those of the disease. I 
admit that this is a somewhat mechanical proceeding, but infi- 
nitely superior to a blind and speculative treatment. 

Section 94. 

This is the proper place to say a few words about the ise- 
pathic method. This method is based upon the principle, 
" cequalia (zqualibus sananda" or, to cure diseases we must 
employ remedies that produce not similar but the same dis- 
eases in the healthy organism. The author of the isopathic 
doctrine, J. J. W. Lux, of Licipsic, bases it upon the following 
facts : 

1. Frozen limbs are cured by cold, burns by heat. This, 
however, can be accounted for, without alluding even to iso- 
pathy. It is well known that powerful dynamic oppositions, 
if succeeding each other immediately, are dangerous and even 
fatal to the vital force which recovers itself most certainly by 
the gradual diminution of the noxious influence. A drunkard 
is not deprived of his brandy suddenly, and a frozen individual 
is covered with snow, because snow, although cold, yet is not 
■as cold as the medium in which the congelation took place. 
To this class of cures belong— 


2. The cures of certain drug-diseases, by high potencies of 
the same medicine. I have no doubt, however, that many false 
statements have been made in this respect. /Schmid observes, 
very justly, that, in many cases the development of the disease 
has been mistaken for the effects of the medicine which had 
been given in a somewhat large dose, and a smaller dose of 
which afterwards cured the disease. Cases of this kind will 
be found recorded § 108. Kammerer relates a few cases of 
diarrhoea arising from poisoning by copper, whieh was cured 
by small doses of copper. The patients had discharged by the 
mouth and bowels, and it is probably this ejection of the poi- 
sonous substance which effected the cure. We may likewise 
record as isopathic cures — > 

3. The cures of the bites of serpents by parts of the serpent; 
such cures are mentioned by older writers. It is difficult to 
separate truth from falsehood in this matter. It is evident that 
superstition and prejudice play an important part in such cases. 
Wounds inflicted by a dog, whether rabid or sound, are covered 
with a cluster of its hair. The brilliant result of such treat- 
ment is, however, no better known than those remedies are 
isopathic to the disease. 

Vaccination is referred to as an isopathic process. It is in- 
deed true, that the vaccin is a preventive against small-pox ; 
but it is by no means certain that all preventives are curatives. 
I refer to Thorer's fine critical remarks on that point in the 
Homoeop. Gazette, Vol. II., No. 19. Of more importance are — ■ 

5. The cures which have been effected with the products 
of contagious diseases, and which contain the contagium. 
Batzendorf and JEgidi assure us that attenuated vaccin short- 
ens the course of small-pox and renders the disease milder. 
Weber has cured with anthracin a number of animals affected 
with anthrax. In my own practice, I have seen a number of 
cures with that brilliant remedy, which has never failed in my 
hands, except where other remedies were used simultaneously, 
or where the disease set in with such fury that it became fatal 
in half an hour. It is well known that the itch has frequently 
been cured with psorin or psoricum. Attomyr relates a rapid 
cure of scald-head with psorin. Veith recommends herpetin 
for the cure of herpes. Kolinski tells us that he has cured 
gonorrhoea in eleven days with gonorrhoin. Similar cures are 
related of ozaenin, and other products of disease. 

Many cases of successful isopathic treatment have been re- 
lated by such undoubted authorities, that they must be credited. 
Enthusiastic partisans of this new system have, however, been 
too hasty in their generalizations, and have mixed up our Ma- 


teria Medica with the most disgusting things, for the benefit of 

Section 95. 

In a work which is simply intended to develope general 
therapeutic principles, no special rules of treatment in particu- 
lar diseases will be expected. It may be appropriate, however, 
to offer a few general remarks. 

Acute diseases, which authors are so particular in distin- 
guishing from chronic, are characterized by the more violent 
reactions of the vascular system, and by the rapidity with 
which they run their course. I will not discuss the question 
whether there are primary fevers, where, according to the doc- 
trines of our neuro-pathologists, the disturbance of the sentient 
sphere is first manifested in the circulatory system. In my 
judgment it is unnecessary to lay down special rules for the 
treatment of acute diseases. The great point is here, as in 
every other class of diseases, to remove the cause. It is of im- 
portance to pay attention to local affections, which sometimes 
only manifest themselves by an increased sensitiveness of the 
diseased part to contact. Such local affections are, for instance, 
aphthae of the intestinal canal in typhus, which, frequently, do 
not cause any pain until pressure is made on the abdomen ; 
and the inflammatory affections of the vertebral column which 
frequently remain unnoticed until the sensitiveness of the af- 
fected part is discovered by pressure ; the frequently deep-seated 
and concealed affections of the liver and spleen likewise belong 
to the category of local affections. John Marshall relates cases 
where the symptoms indicated an affection of the heart, but 
where the disease actually proceeded from an irritated spot of 
the spinal marrow in the dorsal portion of the vertebral column. 
He observes that phthisis, apparent affections of the liver, car- 
dialgia, chorea, and consumption of the mesentery, frequently 
proceed from the same cause. As a matter of course, homoeo- 
pathic physicians should, at least, be as careful diagnosticians 
as their opponents. 

Section 96. 

In chronic diseases strong antipathic medicines are more 
dangerous than in acute. If such diseases set in after the suc- 
cessful termination of acute diseases, there is less danger. The 
morbid process has run its course, and does not readily com- 
mence anew, although relapses are frequently the consequence 


of the retarded counter-action of the organism. Relapses are 
indeed less frequent under homoeopathic than alloeopathic treat- 
ment, In long-lasting chronic diseases, the counter- effects of 
antipathic remedies are, of course, more prejudicial than in 
acute diseases, the primary effects of the medicine being neu- 
tralized by its counter-effects, and a number of secondary 
symptoms being likewise occasioned by the medicine, which 
complicate the original disease and impede the progress of the 
cure. If patients who have been treated with large antipathic 
doses, afterwards wish to be treated homoeopathically, it is ad- 
visable, if the case permit, to leave the patient without medi- 
cine for a time, in order that the organism may be allowed to 
recover itself from the irritating influences which had been 
brought to bear upon it, and may become more susceptible to 
the action of other remedies. 

Chronic diseases which remain unchanged after using the 
most appropriate remedies, depend either upon some organic 
malformation, or upon some dyscrasia. Such diseases should 
be examined with the greatest care, and be treated by the anti- 
psoric or eucratic remedies. 

Spontaneous cures scarcely ever happen when the disease 
depends upon a dyscrasia. In the treatment of such diseases 
the totality of the symptoms is a more certain guide for the se- 
lection of a remedy, than in acute diseases, inasmuch as there 
is less danger of interfering with a beneficent reaction. 

Section 97. 

The efficacy of the homoeopathic treatment in inflamma- 
tory diseases has been disputed so obstinately by the oppo- 
nents of the new method, that a few remarks on that subject 
may not be out of place here. My opinions on the subject of 
inflammation have been derived from a careful and persevering 
study of the ancient and modern theories, and from the results 
which I have witnessed in the treatment of inflammatory dis- 
eases, according to the different views of pathologists. 

Inflammation, whether local or reflecting a constitutional 
disturbance, is always characterized by pain, redness, swelling, 
and increased warmth of the affected part ; the fever and other 
concomitant symptoms either depend upon a previously exist- 
ing, more general disturbance of the organism, or upon the de- 
gree of sympathy existing between the organism and the local 
affection. Hippocrates thinks that inflammation is simply an 
accumulation of blood in parts which usually do not contain 
any. According to Erasistratus r inflammation arises from 


the blood rushing into the small arteries, and disturbing the 
spiritual essence which they contain ; Celsas coincides with 
this opinion. Afterwards the physiological character of in- 
flammation became a subject of study, and, as a matter of 
course, the blood and its vessels attracted the principal atten- 
tion. Galenus derives the accumulation of blood in the small 
vessels, and the effusion of blood into the cellular tissue, from 
congestion and obstruction of the vessels ; Boerfiaave from ob- 
struction of the vessels in consequence of the viscidity of the 
blood ; Ludwig from obstruction of the veins. Others have 
thought that inflammation depends upon the quality of the 
blood. Sydenham speaks of an inflammatory condition of the 
blood, without explaining it any further ; C. L. Hoffman and 
Wedekind derive inflammation from a disposition to acridity 
and putrefaction. Some authors mention an inflammation of 
the blood itself, haematitis. Most authors suppose that an in- 
creased action is the essential character of inflammation. Pre- 
vost thinks that the essential character of inflammation is an 
increase of arterial action, with distention of the blood-vessels ; 
Hunter, that it is a reaction of the vital force against stimuli ; 
Cullen, that it is a spasmodic constriction of the arteries ; Bar- 
tels, that it is an increased action of the capillary vessels which 
contain nothing but lymph in their sound state, accompanied 
with increased oxydation, which is likewise admitted by Reil ; 
Meckel, that it is a local exaltation of the vital action ; Gmelin, 
an increase of the reproductive power ; Wendt, an increased 
action of the vascular system, on which account asthenic 
inflammations are impossible ; Walt her, a blazing up of a pre- 
viously unknown vital fire in single organs ; Carus, a locally 
appearing vascular or reproductive life ; Brandts, an increased 
energy, with proportionate increase of vegetative action ; Krcy- 
sig, an increased intensity of vitality. Burserius, Gorter, 
Gantier, and most other pathologists, agree with those defini- 
tions. iStahl considers the inflammatory process a salutary 
reaction for the purpose of preserving the body, an opinion 
with which Hunter agrees in some respects, in designating the 
nature of inflammation as a reaction of the vital force against 
stimuli. Gruithuisen entertains pretty much the same view 
of inflammation ; according to this author, inflammation is an 
increase of the vital activity, preceded by depression. 

In contradiction to all those opinions, some authors pretend 
that the essential character of inflammation, is a decrease of 
vital action. According to Vacca, for instance, it is a weakness 
of the capillary vessels ; according to Pistelli, a diminished 
contraction and depressed activity of the vessels. Gregory, 


likewise, inclines to that opinion ; according to him, debility, 
want of irritability, atony, are predisposing causes of inflam- 
mation. His opinion is derived from the fact that feeble sub- 
jects are most liable to inflammations. Rcil, Gruithuisen, and 
many others, likewise admit that debilitating influences predis- 
pose to inflammatory diseases. That there should be such a 
variety of opinions about the essential nature of inflammation, 
is so much more astonishing, as no diseases are more frequent 
and have been observed and described with more perseverance 
than inflammatory. What is still more striking, is the fact that 
pathologists do not as yet agree about the diseases which be- 
long to the inflammatory kind. Marcus says : every disease 
of the irritable system, from synocha to typhus, has an inflam- 
matory character. Fillippi thinks that inflammation is the 
common source of all diseases. According to Broussais, all 
diseases are inflammatory ; and Schoenlein says, likewise, that 
every disease might be considered a species of inflammation. 
Lallemand goes so far as to derive involuntary emissions from 
an inflammation of the seminal vesicles. Such a confusion of 
ideas cannot possibly be advantageous to science. It arises 
from the fact, that inflammation has been supposed to arise 
from the quantitative or qualitative relations of the inflamed 
part. This one-sided opinion cannot lead to any certain re- 

Section 98. 

The seat of inflammation is the capillary system. The 
well known microscopic investigations of Vacca, Cruikschank, 
Wilson Philipp, Thomson, Hastings, Gruithuisen, Koch, 
Kattenbrnnner, etc., have shown that inflammation is charac- 
terized by stagnation of the circulation, dilatation of the vessels, 
subsequently alteration of the blood, and transformation of one 
portion of the organic substance itself into a pappy mass. 
These are permanent phenomena, occurring in every case of 
inflammation. Less permanent are the exudation of coagula- 
ble lymph ; the formation of new vessels and capillary nerves ; 
the more or less active reproduction of organic substance gen- 
erally ; or, if the reproductive power should be entirely pros- 
trate, and the inflammatory process should have the charac- 
ter of erysipelas, the gradual extinction of the vitality of the 
affected parts, with symptoms of gangrene and with formation 
of ichor. The focus of inflammation, is the capillary system, 
the lymphatic vessels being more or less involved. The origi- 
nal physiological character of the capillary vessels disappears, 
and is at times arterial, at others venous. The true nature of 


the inflammatory process is, therefore, to disturb the relation 
of indifference between artery and vein. 

The proximate cause of inflammation, is neither in the 
blood, according to C. L. Hoffmann, nor in the arteries, accord- 
ing to Marcus, nor, according to Ludwig, in the veins. It is 
in the source of animal life, the nervous system, the regulator 
of all vital functions ; and more particularly in the capillary 
nerves which maintain the equilibrium between the arterial 
and venous action, and, in disease, induce a predominance of 
one or the other, with either synocha, erysipelas, or asthenia. 
Bell, Hull, Wilson Philipp, Magendie, Flour ens, Panissa, 
Bellingeri, John Mutter, and many others, admit the existence 
of that nervous influence. Duges refers to the anatomical fact, 
that the ganglionic system of nerves which presides over the 
process of nutrition, is connected with the arteries, and that the 
terminal filaments of those nerves are lost in the walls of the 
finest vessels, so that the nervous substance and the substance 
of the arteries become one. The nervous arteries penetrate 
every tissue, are instrumental in the secretory process, and are 
the seat of inflammation. According to Most, the morbid affec- 
tion passes from the nerve, which is the regulator of vital ac- 
tion, to the blood, and an opposite affection takes place, which 
counterbalances the nervous disturbance. That opposite affec- 
tion is the inflammatory process. Karl linger expresses him- 
self as follows : every inflammation arises from an irregular 
direction of the vital force, occasioning in single organs or in a 
number of organs at once, alterations of the substance, which 
manifest themselves as abnormal secretions or new formations. 
According to Baumgaertner, a certain something which is ac- 
tive in the nerves, has an essential part in all vital functions. 
That something either occasions disturbances in other parts, or 
else is itself affected separately from other parts. In the former 
case, fevers and inflammation set in ; in the latter, purely ner- 
vous diseases. According to Marshall, the vascular system 
owes its energy and vital power to the nervous system ; hence 
nervous weakness is the most frequent cause of obstruction of 
the vessels. Naumann says : a violent irritation prevents the 
equal and harmonious extension of the nervous impulse pro- 
ceeding from the centre. The nerve of nutrition is changed to 
a sentient nerve ; the determination towards the brain increases 
in proportion as the action towards the periphery is diminished. 
The blood in the capillary vessels of the irritated part loses its 
vivifying properties in the same proportion, and those properties 
assume a hostile irritating character. Sundelin shows very 
clearly the influence of the nervous system upon digestion, 


chylification, and reproduction, the focus of which is the capil- 
lary system. According to Hausmann, inflammation arises 
from the action of the nervous system, particularly of the ner- 
vous power in the veins and transition-vessels between the 
arteries and veins, upon the blood. The influence of the ner- 
vous system upon the blood, is demonstrated by a number of 
phenomena. I mention the sudden blush induced by shame, 
and the pallor in consequence of fright. Fabricius shows the 
connection between the nervous system and miscarriage. Wil- 
son Philipp shows the influence of the spinal marrow on the 
motion of the heart. I will not discuss Laennec's opinion that 
gangrene of the lungs is a consequence of depressed vitality, 
and not a termination of inflammation. Why should not in- 
flammation and a depression of vital action, coexist? Violent 
inflammatory diseases are preceded by nervous affections, gen- 
erally by a violent chill. Last winter, when peripneumonia 
was a prevalent disease in this district, I have frequently suc- 
ceeded in cutting the disease short and restoring the patient to 
perfect health within twelve hours, if I was called to the patient 
during the chill. It is, indeed, not mathematically certain whe- 
ther inflammation would have set in ; but I will state the facts 
and mention the means which I used : in three cases, icy-cold 
water, a tablespoonful every five minutes ; and in two other 
cases, characterized by sudden, excessive prostration and cada- 
verous paleness, a small dose of Arsenic. It is remarkable that 
pain sometimes precedes the inflammation, and, instead of aris- 
ing from the swelling and from the pressure upon the nerves, 
is a primary affection of the latter. On combining the remarks 
which have been offered, and carefully considering the whole 
process of inflammation, there cannot remain a doubt that the 
proximate cause of inflammation is a disturbed vitality of the 
capillary nerves. As soon as the influence of the capillary 
nerves upon the parts with whose substance they are intimately 
interwoven, is disturbed, the capillary vessels either become 
arterial or venous, and the blood itself is correspondingly 
changed, exhaustion and depression of the reproductive activity 
frequently attending the inflammatory process, according as the 
nervous influence has undergone one change or another. On 
this account, inflammations may be sthenic or asthenic, and 
there is no reason not to set down as inflammatory diseases, all 
those which are characterized by local pain, redness, increased 
warmth, and swelling. 

It has been pretty generally assumed that an increased 
sanguification is an essential symptom of inflammation. An- 
dral goes so far as to substitute the term hyperemia for in- 


flammation, whereas Cayol shows that no traces of inflam- 
mation have been discovered after death, in bodies which had 
been visited with violent inflammations. There are still more 
convincing arguments against the supposition of an increased 
formation of blood ; the most important of which is undoubt- 
edly the fact that, in the most violent inflammatory diseases, 
with excessive orgasm of the blood, and where neither natu- 
ral nor artificial depletion had taken place, no symptoms of or- 
gasm or plethora could be perceived immediately after a crisis 
had set in. What could have become of the blood, if there 
was too much of it? On the other hand, if we consider how 
rapidly an inflammation sometimes sets in, it is difficult to 
comprehend how the blood could have accumulated in so 
short a time. 

Section 99. 

The opposition between the antipathic and the specific 
method of cure is nowhere more decided than in the treatment 
of inflammatory diseases. The former, upon the supposition 
that there is an excess of blood in inflammations, resort to pro- 
cesses of depletion, which are almost unanimously condemned 
by the partisans of the New School. Older physicians even, 
particularly Asclepiades and Erasistratus have pronounced 
against bleeding, and even Galenus, who frequently recom- 
mended venesection, says that it is not necessary in every tur- 
gescence, and that plethora can be removed by frequent bathing, 
exercise, and frictions. Celsus and Forest censure the im- 
moderate resort to the lancet, and there have been physicians 
at all times who have pointed out the pernicious consequences 
of excessive bleeding. Y. Seeds says that water forms in 
the brain during profuse bleeding, and that the bleeding should 
never be continued until the patient's tongue becomes cold 
and the pupil immovable. Speranza has observed that the 
number of deaths among the pneumonic patients of Brera is 
proportionate to the number of venesections inflicted upon 
the respective patients. Of one hundred patients treated 
without bleeding, fourteen died ; of one hundred treated with 
two or three venesections, nineteen died ; of one hundred pa- 
tients who had been bled from three to nine times, twenty-two 
died ; and of one hundred who were bled more than nine 
times, sixty-eight patients died. According to the statistical 
list of Weiglein, in all those cases of inflammation that were 
treated according to the rules of the Brunonian School without 
bleeding, the crises set in later, the convalescence was more 


rapid, and the transition into adynamic fevers was much less 
frequent. Nehrmann observes that the bloed frequently be- 
came stagnant in the lungs in consequence of bleeding, and 
that the patients were threatened with suffocation. Kuhl- 
brand mentions that persons who were suffering with inter- 
mittent fever, and angina pectoris, were speedily attacked with 
typhus, or with profuse secretion of mucus in the chest, after 
being bled one cupful only. In order to prevent such pernicious 
consequences, Beddoes employed strong stimulants imme- 
diately after bleeding. 

In cases where depletion was of no avail, or where the 
patient was too feeble to lose much blood, leeches or cupping 
has been resorted to, to relieve the surcharged vessels. The 
relief thus obtained is of short duration, inasmuch as the 
afflux of new blood cannot be prevented. If there be any 
use in local bleeding, it is simply this, that the mass of blood 
is generally diminished. Berres has proved this conclusively, 
(see Med. Annals of Austria, vol. X.) Somme is quite right 
in saying that the loss of a few ounces of blood will not pre- 
vent the column of blood from carrying the morbid process to 
that spot. Even if one half of the whole mass of blood were 
taken from a man, enough would be left for a violent inflamma- 
tion. Even the last drop might still be food for inflammation. 
I recollect that in the report of a certain post-mortem examina- 
tion, it was said that traces of an internal inflammation had been 
discovered, which could not be controlled in consequence o 
the feeble condition of the patient preventing a sufficient 
abstraction of blood. The doctors ought rather to have stated 
the case thus : We, who do not understand the better method 
of curing inflammatory diseases without the lancet, have been 
unable to save this patient's life. Physicians are frequently 
placed in the unfortunate dilemma of either reducing the 
patient to a fatal debility, by bleeding, or of letting him die of 
the inflammation. My official position enables me to see a num- 
ber of young men who are dismissed from the hospitals as 
convalescent; if they had been treated for inflammatory dis- 
eases in the usual fashion, by bleeding, they look like skele- 
tons, and scarcely ever regain their strength. What immeasu- 
rable advantages the specific method offers in regard to con- 
valescence ! If the inflammation, pneumonia, pleurisy, &c, be 
cured, our patients are at once able to resume their ordinary 
avocations. In the last year 1 have treated, at least, forty- 
patients for pneumonia, and have cured them all. He who 
has seen such brilliant results cannot help lamenting that 
emaciated individuals, if attacked with an inflammatory dis- 


ease, should be deprived of their last strength by bleeding. 
Robertson advises to draw from forty to forty-eight ounces of 
blood at once in pneumonia. Broussais orders hundreds of 
leeches at once, and finds imitators- Posterity will sit in judg- 
ment over this vampyrism, and pronounce a terrible condem- 
nation upon it. 

Section 100. 

It may seem paradoxical to assert that every inflammatory 
disease depends upon an absolute or relative weakness of the 
vital force ; this is, nevertheless, true. For if the vital force 
were strong enough, it would counterbalance, or overcome 
every morbific influence. There are organisms that are strong 
enough to resist almost any contrary influence. With this 
intensive power of the vital force, the manifestations of an 
extensive exaltation of the vital functions must not be con- 
founded. In every morbid condition, even in adynamic 
fevers, where the pulse is frequently uncountable, single func- 
tions may be carried on with more rapidity. Out if inflamma- 
tion be caused by the disturbed vitality of the capillary nerves, 
resulting in an abnormal process of sanguification, the true 
remedy cannot be a one-sided diminution of the turgor vitalis 
in the capillary system ; such treatment is merely symptom- 
atic and palliative, and does not remove the cause. Venesec- 
tion may be necessary 

1. In those rare cases of true plethora, where the sensible 
sphere is overwhelmed by a profuse sanguification ; and 

2. In cases of congestion of noble organs, violent inflam- 
mation of the brain or lungs, where there is imminent danger 
of apoplexy in the former, and of asphyxia in the latter case- 
in these cases venesections simply avert the danger of a fatal 
retroaction of the morbid product, but do not cure the disease ; 
this has to be accomplished by restoring the normal dynamic 
relation between the nervous and sanguineous systems. If this 
be not attended to, every drop of blood may be taken from a 
man without curing him. Every depletion diminishes the 
vital power, whereas the vital action of the organism should 
be rendered more intense in order to overcome the disturbing 
influence. Brown's method is to stimulate the vital action by 
his excitants. The increase of vascular excitement which fre- 
quently succeeds the use of those excitants, Beddoes endeavors 
to prevent by first bleeding the patient. This method is pur- 
sued by a number of other physicians ; they first bleed, and 
then give Serpentaria, Camphor, Moschus, to repair the mis- 


According to the specific method, inflammations are cured 
by giving small doses of a remedy which is capable of realizing 
a similar inflammatory condition ; such a remedy excites the 
vital energy intensively, and enables it to restore the true rela- 
tion between the capillary arteries and veins. 

Although this is not the place for special therapeutic rules 5 
yet I may mention that Aconite is no universal specific for 
inflammations. Aconite is suitable to synochal inflammations 
of parenchymatous parts ; Bryonia is the remedy when such 
inflammations threaten to assume the typhoid form; Bella- 
donna corresponds to inflammations of the brain, and generally 
to inflammations characterized by excited nervous action ; 
Pulsatilla to inflammations with a venous character ; Arsenic 
to inflammations attended with threatening paralysis of the 
capillary nerves, and consequent disposition to decomposition 
of substance 5 and extinction of the organic life* 

Section 101. 

In the treatment of mental diseases, the specific method 
is very efficacious. This has been confirmed to me by abun- 
dant experience. 

Inveterate mania, which has been getting worse from 
year to year, leaves very little hope, particularly when the 
patient had for years past a malicious, artful disposition. Me* 
lancholia is likewise incurable as long as the causes which 
influence the soul are not removed. According to Hahnemann) 
psora acts a principal part in those affections. This statement 
ought to be received with some allowance. There are cases 
where the brain suffers vicariously in consequence of a sup- 
pressed or disappeared eruption ; in such cases, and indeed 
in every case of mental derangement, the treatment must be 
conducted with reference to the cause of the disease. Accord- 
ing to Heinroth the soul is directly diseased ; sin is the cause 
of that disease which arises from the connection established 
between evil and the soul. The soul has given itself up to 
evil, and is bound with the chains of darkness. According to 
Friedreich, the soul is the organic vital force which manifests 
itself in its highest form as an active principle through the 
most perfect material structure, the cerebral system. The 
soul itself cannot be attacked with disease, and the cause of 
physical diseases lies in the material structure. This differ- 
ence of opinion seems to arise from the fact that disease and 
offended morality are confounded by those authors. A trans* 
gression of morality may take place without disease, but may 


lead to disease. Remorse may occasion a real and even incu- 
rable disease. This disease, developing itself within the sphere 
of the senses, is a proper object for treatment. The object of 
this treatment is to remove the cause. Formerly the cause 
was supposed to reside in the blood, in consequence of which, 
bleeding was recommended by Celsus, Avicenna, Alexander 
de TraJles, Paracelsus, Riviere, Riedlin, Hamilton, Spnrz* 
heirn, Rnsch, and others. Van Swieten has seen bleeding 
followed by incurable idiocy, and a number of modern physi- 
cians, particularly Atnelung, have either condemned bleeding 
altogether, or have restricted its use. For six years past I have 
not shed a drop of blood, and have cured a number of insane. 
Mental diseases are very frequently secondary consequences of 
diseases of the ganglionic system, of infarctions of the liver and 
spleen, where specific remedies are much more to the point than 
cathartics and injections. 

Puerperal mania is generally accompanied with sympho- 
mania, although this seems incredible. Robert Gooch recom- 
mends venesection and cathartics for that disease. Pulsatilla, 
Lachesis, Arnica, Cantharides, Platina, etc., are much more 

I cannot give any special rules for the treatment of mental 
diseases. I must observe, however, that insane patients, and 
particularly monomaniacs, are frequently treated most cruelly. 
The attendants dispute with the patient, and require him to 
believe that he is mistaken. If he could believe this he would 
not be sick. It is true that a good deal of patience and self- 
contiol is required on the part of those who treat mental dis- 
eases ; expressions of ill will destroy the confidence of the pa- 
tient, and make the treatment unavailable. 

Section 10*2. 

In complicated diseases we require to find out whether 
they coexist accidentally and independently of each other, or 
whether one is caused by the other, or whether the several dis- 
eases have become so intimately united that a new morbid 
condition, with distinct and characteristic symptoms, has arisen 
from that union. 

In the former case, the more important disease is to be re- 
moved first, then the less important. If a man, treated for 
herpes or itch, should be attacked with the influenza, with dys- 
entery or pleuiitis, the treatment of the chronic malady has to 
be interrupted until the acute disease is cured. If the disease 
which breaks out some time after the former, should be a mere 


development of this one, the two diseases constitute an unit, 
and it would be wrong to treat each separately. Hahnemann 
teaches in his Organon that, if a medicine should only remove 
part of the symptoms, or should occasion a train of secondary 
symptoms, another remedy is to be chosen in accordance with 
the new group of symptoms, and that this course is to be con- 
tinued until all the symptoms have disappeared. I cannot 
agree with Hahnemann in this matter. Only two cases can 
occur. The remedy either corresponds to the focus of the dis- 
ease, or to the sympathetic affections. In the former case the 
patient, if not cured, must feel decidedly better. If the im- 
provement cease, it is because the action of the remedy is ex- 
hausted ; in this case the dose has either to be repeated, or else 
a new remedy has to be chosen which corresponds more closely 
to the new group of symptoms. In some cases sensitive organs 
are so powerfully affected sympathetically, that they remain 
sick even if the focus of the primary disease should be extin- 
guished. In such cases the remaining symptoms should be 
treated as an idiopathic affection. If a remedy do not corres- 
pond in any degree to the focus of the disease, but merely to 
some of the sympathetic phenomena, it cannot accomplish any 
thing except to modify the form of the disease. On perceiving 
this, we should at once institute another and closer examina- 
tion, and select a more appropriate remedy. Dyscrasias act 
an important part in complicated diseases, and impede the 
treatment of both acute and chronic diseases. Acute, or even 
inflammatory diseases of persons who had been ever so little 
affected with herpes, frequently resist all treatment, until a dose 
of Sulphur or Lycopodium, or some other appropriate anti- 
psoric remedy is given, after which a rash-like erythema fre- 
quently makes its appearance, when the acute affection yields 
at once to the ordinary treatment. This is likewise the case 
with chronic diseases. Figwarts frequently do not get well 
without a few doses of sulphur, and, if a scrofulous child be 
attacked with the itch, the latter has to be removed first, before 
the scrofulous affection can be arrested. 

Section 103. 

Sivoons, apparent death, and similar conditions where the 
vital action is quite prostrate, requires the momentary use of 
stimulants. Paroxysms of asphyxia in children have indeed 
been cured with Chamomilla, which I have likewise success- 
fully used in asthma thymicum, as long as consciousness had 
not entirely gone, and no fainting had set it ; Petroz speaks 


very highly of Bovista in attacks of asphyxia from the vapor 
of coal, and of the Solanum mammosum in the asphyxia of 
drowned persons. Elwert and Heichelheim have cured 
apoplexy with Opium, Belladonna, and Cocculus. Malaise 
has cured a case of apoplexy with paralysis of the left side 
with one dose of Belladonna, in twelve hours ; the patient was 
a young man. In all those cases the reaction had not yet 
ceased. But when there is a perfect collapse of pulse, and the 
breathing has stopped, the volatile stimulants have to be re- 
sorted to to rouse the vital action. Hartmann lays down 
excellent rules for such a contingency in his treatise of acute 
diseases. There are cases where a little bleeding may be ne- 
cessary, not to diminish the mass of blood, but to excite the 
circulation. If, after the vital energy is roused, consequences 
of the attack, paralysis or convulsions, etc., remain, well-chosen 
specific remedies will remove them. 

Section 104. 

The derivative method has enjoyed great repute for sev- 
eral thousand years past, and, with much evil, has done some 
little good. It is not my intention to defend cathartics, moxse, 
setons. I confess, however, that I never hesitate to avail 
myself of all the means at my command, to relieve the pa- 
tient. In measles and rubeola, when the eruption was slow to 
come out, when oppression of the chest, anguish, and restless- 
ness, with unequal and spasmodic pulse were present, I have 
not hesitated to apply a sinapism to the chest, which gener- 
ally brings out the eruption in a couple of hours, and changes 
the whole scene. When dangerous symptoms set in, in con- 
sequence of the sudden suppression of tinea capitis, I do not 
hesitate to cause the head to be washed with mustard-water ; 
in asthmatic difficulties, consequent upon the indiscreet sup- 
pression of old ulcers of the feet, I cause the cicatrices to be 
covered with an ointment of tartar emetic, or cantharides, or 
to be acted upon by the vapor of hot water, in order to excite 
the wound and draw blisters. I do not hesitate to employ 
warm foot-baths in violent congestions with vertigo and stu- 
pefaction, hand-baths in excessive secretion of milk ; in sudden 
suppression of habitual sweat of the feet, I have them placed 
in hot sand, and socks of oiled-silk put on. Hahnemann first 
recommended to apply pitch-plasters to the back, but rejected 
them afterwards. I have used them frequently, but have 
never derived great benefit from them. On the other hand, I 
am convinced that it would be unwise suddenly to close an 




issue that has been running a long time. Counter-stimulants 
are likewise useful in some cases. In hundreds of cases of 
injuries of the head, with more or less violent concussion of 
the brain,- 1 have used applications of cold water, or ice and 
snow, with incalculable benefit, and have, moreover, convinced 
myself that such applications do not interfere with the action 
of Arnica administered internally. In croup, Griesselich has 
a sponge soaked with hot water applied to the throat, at the 
same time that he uses internal remedies. Why should not 
local relaxing applications be made to highly inflamed parts 
with excessive tension ? 

Section 105. 

The magnitude of the dose is a subject of great impor- 
tance. Opinions on this head differ a good deal. I have 
devoted the most careful attention to the subject of doses, and 
consider myself entitled to lay the results of my experience 
before my readers. The lowest as well as the highest prep- 
arations have been recommended as normal doses. Either of 
these two extremes is condemnable. There are no normal 
doses. It is likewise false that any dose, were it ever so small, 
is yet powerful enough to overcome the morbific influence. 
Schmid of Vienna gave his own child, who was dangerously 
sick with the smallpox-fever, the fourteenth potency of Belladon- 
na, which was the remedy indicated. The danger, however, 
augmented steadily, and the exanthem would not make its ap- 
pearance. Schmid, who was convinced of having selected the 
right remedy, now gave a drop of the first attenuation, after 
which the fever abated very soon. I have seen similar results 
in a number of cases, even a few days previous in a case of 
venons metrorrhagia, where the sixth attenuation of Crocus 
had no effect whatever, and where one drop of the second 
attenuation manifested the most beautiful results after the 
lapse of ten minutes. In a case of dyspepsia with vomiting 
the third attenuation did no good ; three drops of the first 
attenuation, in a cupful of water, a tablespoonful every two 
hours, effected a rapid improvement. Experience like this has 
induced many physicians to give larger doses under certain 
circumstances. Other physicians advocate the exclusive use 
of the higher attenuations. Some even give medicines only 
by olfaction. Very sensitive, hysteric females are, indeed, 
affected by merely smelling of the medicine, but the reaction 
occasioned by olfaction is very fleeting at any rate. If different 
systems and organs be affected, the cure is promoted by giv- 
ing two remedies, one of which corresponds to one and the 


other to the other affection, in alternation. Digitalis and Nux 
vomica, for instance, may be given alternately in a complica- 
tion of pneumonic and gastric symptoms, Sulphur and Nux 
vomica in chronic abdominal complaints. Some physicians 
are indifferent to the magnitude of the dose. It has been 
asserted that the dose is of not much consequence, and that 
cures can be performed with large doses as well as small ones, 
provided the remedy is exactly specific to the disease. Physi- 
cians who reason in this way, must overlook all physiological 
laws. The followers of every school have made it a rule to 
determine the magnitude of the dose by the irritability and 
reactive power of the organism. Tournier says that the irri- 
tability of the organism is a very uncertain standard for the 
magnitude of the dose. It is, indeed, no mathematical demon- 
stration, but by combination and reflexion we have been ena- 
bled to discover whether the sensibility of the organism is 
increased or diminished, and whether much or little medicine 
is required to affect the diseased part. Bethmanti, who is on 
the side of the small doses, says : The susceptibility of the 
organism to medicinal action differs in different individuals ; 
the magnitude and repetition of the doses depend upon that 
susceptibility. Fielitz advises to regulate the dose according 
to the susceptibility of the organism. Backhausen is of the 
same opinion. Werber expresses himself very clearly, thus : 
Every disease requires a proportionate quantity of medicinal 
action, in order that the organism should not be excited too 
violently or too feebly. Trinks and Rummel likewise speak 
of the necessity of graduating the dose. These quotations 
will suffice. It remains for me to show by what circumstances 
the magnitude of the dose should be regulated. 

Section 106. 

When the organism is exceedingly sensitive to medicinal 
action, smaller doses are required than if the contrary were 
the case. 

All experienced practitioners agree on this point. Physi- 
cians who possess a knowledge of physiology, know, likewise, 
that sensibility and reactive power do not always go apace, 
and that they frequently hold inverse relations to each other. 
The magnitude of the dose is always regulated by the degree 
of sensibility. The following points have to be considered in 
determining the dose. 

1. Age. The sensitiveness to heterogeneous medicinal in- 
fluences is'most intense in children, and diminishes as man 


grows older. Hence children require less medicine than 
old people. There are exceptions to this rule. Growing 
individuals are particularly sensitive, and the greatest sensi- 
tiveness is possessed by organs engaged in the process of ev- 
olution ; medicines which are specifically related to those 
organs have to be given in small doses. 

2. Constitution. The higher attenuations are particu- 
larly suitable to persons with a sanguine or choleric tempera- 
ment. More massive doses are required for phlegmatic and 
torpid constitutions, and are more especially necessary in the 
case of persons who have blunted their sensibility by the ex- 
cessive use of brandy, wine, coffee, tea and spices. There is 
a constitution which Hufeland designates by the appellation of 
torpid vigor. It is characterized by great muscular strength 
and an energetic reactive faculty, which, being little sensitive, 
requires to be roused by powerful stimuli. People who have 
such a constitution, bear large quantities of spirituous drinks 
without getting intoxicated. They likewise require larger 
doses of medicine in case of illness. 

The constitution is decidedly influenced by climate and 
mode of life. According to the reports of physicians, the peo- 
ple of Petersburgh in Russia require larger doses than the 
inhabitants of southern regions. I know from my own ex- 
perience that Frenchmen, Spaniards and Italians are more 
easily effected by medicine than Englishmen. The sensibility 
is increased by mental occupation, excitement of the fancy, 
novel-reading, sedentary life, long sleeping, and effeminacy of 
any kind. Less sensitive are those who do heaw work in 
the open air, sleep little, and live on coarse food. I have ob- 
served that tobacco-chewers and persons who work in tobacco- 
manufactories have very little sensitiveness to the action of 
medicine. The sensibility is likewise diminished by living in 
drug-shops, vinegar and brandy distilleries. Individuals who 
have been dosed with a variety of drugs, particularly metallic 
drugs, bear and require much larger doses. 

The female sex is generally more sensitive to medicine 
than the male ; the latter possesses more reactive power. 
Mansfeld and Majons have observed that the deaf and dumb 
require larger doses of medicine. According to their experience 
the whole nervous system of such patients is too dull to be 
easily stimulated by heterogeneous atmospheric or other in- 
fluences. A higher degree of temperature, which would in- 
crease the pulse of persons with sound hearing by sixty, 
increased it only by twenty beats in deaf persons. 

3. Nature of the disease which we are called upon to 


treat. The rapidity with which the disease runs its course, is 
a matter of little consequence ; the rapidity of that course may 
depend upon the increased rapidity of the vital process, as 
well as upon the complete collapse of the vital functions and a 
complete dissolution, as in the worst form of cholera. In the 
former case the high, in the latter the low attenuations are 
preferable. The former are suitable to an erethic condition of 
any kind, the latter to torpor. Werber has cured hydrothorax 
in old people with the tincture of Digitalis, Reubel the cholera 
with whole drops of the tincture of Phosphorus. In inflam- 
matory affections of the meningeal membranes with convul- 
sions, in the case of children, I have seen the most remarkable 
curative effects from the forty-fifth potency of Belladonna. 
In typhus versatilis the twentieth, even the thirtieth attenua- 
tion of Bryonia, Belladonna, Rhus, Phosphorus, etc., may be 
of great benefit ; whereas in typhus stupidus and putridus, 
massive doses of the proper remedies, Hyosciamus, Coccu- 
lus, Phosphoric acid, Cuprum, Mercurius and Arsenic, are 
required. In inflammatory diseases with increase of arterial 
action, the higher attenuations act best, in venous inflammations 
the lower. The same remark applies to haemorrhage. Crocus, 
which corresponds to venous haemorrhage, is given lower 
than Sabina, which is more suitable to arterial haemorrhage. 
Some very respectable authors pretend that the higher atten- 
uations are more suitable to acute diseases, and the lower to 
the chronic. This cannot be considered a general rule. The 
proper standard for the regulation of the dose is the higher or 
lower sensibility of the organism. 

4. Seat of the disease. The more sensible the affected 
organs, the smaller ought to be the dose, and vice versa, pro- 
vided the sensibility of the organ is not entirely prostrate. In 
erysipelas of the head, involving the cerebral membranes and 
causing delirium, one drop of the third attenuation of Belladon- 
na, with which we cure erysipelas of the foot, would be a dan- 
gerous dose. In carditis I have never given lower than the 
thirtieth attenuation of Arsenic, although I give much larger 
doses in hydrothorax and oedema of the lungs. In diseases of 
the mucous membranes, which are inferior tissues, we require 
to give larger doses. In croup I give the sixth attenuation of 
Aconite and Spongia with the best success, and Hepar sulph. 
in the first or second trituration. JSgidi uses the same atten- 
uations in that disease. We may consider it a general rule, 
that in diseases of the vegetative system stronger doses are 
required, unless the character of those diseases should be erethic 
or inflammatory, as in phlegmonous inflammation of the sto- 


mach, in enteritis, cistitis, etc., where the higher attenuations 
are the most suitable. 

In the so-called local diseases, which do not affect the or- 
ganism generally or affect it but very little, for instance in old, 
callous ulcers of the feet, in tinea capitis, otorrhcea, leucorrhcea, 
glandular indurations and adventitious growths, massive doses 
deserve a preference. Of great importance is — 

5. The inherent strength of the medicines. The more 
powerful the medicines are naturally, the greater the necessity 
to employ them in high attenuations, and vice versa. No ex- 
perienced practitioner doubts that Belladonna, Nux vomica, 
Lachesis, Phosphorus, and Arsenic, are still efficacious in the 
twentieth or thirtieth potency ; whereas the higher potencies 
of other drugs, such as Euphrasia and Taraxacum, would be 
of very little use. 

6. The affinity of medicines for single organs deserves 
special consideration. The greater that affinity the more pow- 
erful the action of the medicine. This subject has already 
been adverted to by Kopp, and Liedbeck has observed that 
ulcers of the fauces can be cured with the thirtieth potency of 
Mercury ; whereas ulcers of the genital organs require much 
lower attenuations. Clematis requires to be given in much 
larger doses for cutaneous eruptions than for orchitis ; rheuma- 
tic paralysis requires to be treated with larger doses of Bella- 
donna than meningitis or angina faucium. Aconite has great 
affinity for the throat and respiratory organs, but not for the 
liver ; and, in violent hepatitis requires to be given more fre- 
quently and in larger doses than in angina, pneumonia, or pleu- 
ritis. We must not overlook — 

7. Idiosyncrasies, on account of which certain medicines 
have no effect in some and violent effects in other individuals. 
Some years ago a patient consulted me for some abdominal 
difficulty, telling me at the same time that he could not bear 
Nux vomica, and that it caused him anguish, palpitation of the 
heart, coldness of the limbs and viscid sweats. Supposing all 
this to be mere fancy, I gave him Nux, which was the suitable 
remedy. Two hours after, the patient sent for me and told 
me : you have given me Nux, for I suffer with all the symp- 
toms I mentioned to you. The patient had to take black cof- 
fee to counteract the symptoms. 

8. In some cases, small doses of well selected remedies 
have no effect. If this be not owing to idiosyncratic influences 
antipathic to the action of the remedy, larger doses will cer- 
tainly act. It is supposed by some, that the essence of the 
homoeopathic system of cure is to give small doses, and that a 


larger dose is not homoeopathic. If the remedy be chosen in 
accordance with the principle " similia similibus," the treat- 
ment is homoeopathic, whether the dose be large or small. If 
alloeopathic physicians pretend to treat homoeopathically on 
account of giving little or no medicine, this simply shows that 
they do not know any thing about our doctrines, and are very 
poor practitioners. In the enanthiopathic method it is fre- 
quently necessary to give large and powerful doses, and if a 
physician do not dare to act up to his principle, his timidity is 
a conclusive proof that he is not sure of his business. 

Section 107. 

The repetition of the dose is a subject that has excited 
much discussion in our school. At one time Hahnemann 
taught that medicines act a definite number of days and weeks. 
Some of his disciples pretend, moreover, to have observed that 
certain remedies produce a revolution in the organism four 
weeks after being taken, and that at such a period violent 
symptoms make their appearance for a time. Calm and care- 
ful observers never discover such revolutions. Cures have been 
recorded where the medicine has been said to have acted two 
or three months. A medicine may produce an improvement, 
and this improvement may last months or even years ; but, 
if a recurrence of the original symptoms take place at the end 
of such a period, it would be wrong to infer that the medicine 
had been acting all the time. Large portions of a drug do in- 
deed act a long time, sometimes for months and years. Helbig 
mentions a case where an ounce of the tincture of Ambra acted 
for months. I recollect having removed a placenta which had 
remained in the uterus and had become putrid. The smell 
was horrid. Every morning, for six weeks in succession, I had 
the same sensation on my tongue which that odor had first 
occasioned. If small doses of a medicine act as long as they 
do in some cases, the duration of that action depends upon 
some idiosyncrasy. It is impossible to state a priori how long 
a medicine will or ought to act ; the duration of the primary 
action and the period when the counteraction will set in, depend 
altogether upon the individuality of the organism. Independent 
observers generally agree that medicines do not act as long as 
has first been supposed, and that the action of the remedy had 
better be kept up by repeating the dose. Some homoeopathic 
practitioners abuse this privilege, and are even more officious 
in giving medicine than physicians of the Old School. It is 
such an easy thing to fall from one extreme into another. We 


have no definite rules of practice ; my own rules, which have 
been suggested by experience and observation, are as follows : 

1. I repeat the dose if the violence of the disease have sim- 
ply abated without the character of the disease being essen- 
tially changed ; and if I am satisfied that the improvement 
has remained stationary. 

2. If a repetition of the dose be not followed by a new im- 
provement, the dose has not only to be repeated but at the 
same time to be increased, provided, as before remarked, that, 
the remedy is still indicated. This maxim has been followed 
by the physicians of every school ; for it is well known that 
the organism gradually loses its susceptibility to the same ex- 
ternal influence, until finally all reaction ceases. The organ- 
ism may even become accustomed to poisons. Arsenic had no 
effect on Mithridates, and opium-eaters have to increase the 
quantity to feel the effects of the poison. Why should we not 
avail ourselves of this experience in our practice ? I refer to 

Werber's excellent remarks in the first volume of the Hygea. 
It has frequently been observed that the first dose of a remedy 
occasions an aggravation of the symptoms which is not ob- 
served after subsequent doses. Schindler advises to repeat the 
indicated remedy until reaction sets in, and then to wait until 
the reaction ceases. This seems good advice. Unfortunately 
it is impossible to lay down rules for one who has no practical 
talent and no powers of observation. 

3. In acute diseases, such as violent inflammations, where 
the vital functions are accelerated, and in adynamic putrid fe- 
vers, where the vitality of the organism is rapidly sinking, the 
medicine has to be given more frequently than in chronic dis- 
orders. In the Asiatic cholera the dose has been repeated every 
fifteen or even every five minutes. In violent inflammations 
I give the Aconite every hour, and in meningitis I give the 
Belladonna every half hour. According to JEgidi, the medicine 
may be repeated every hour in acute, and every twenty-four 
hours in chronic diseases. Much depends upon the system or 
organ which is affected. Where there is a high degree of sen- 
sibility and functional action, the effects of the medicine are 
less lasting. In general terms the rule is to watch the effects 
of the remedy and to act accordingly. In acute diseases the 
effects appear much sooner than in chronic. If, in acute dis- 
eases, the medicine do not act within one hour, I consider this 
a proof that it is not the remedy, or that the dose was too weak. 
Even in chronic diseases a well-selected remedy ought to show 
some effect in twenty-four, or, at any rate, in foity-eight hours. 

4. The dose should not be repeated if the medicine have 


produced an essential change in the symptoms. Hering ob- 
serves that the vital force has then exhausted its counter-act- 
ing energy in that direetion, and that a second dose would then 
do injury. I do not believe that any injury would arise from 
such a repetition, nor do I, on the other hand, believe that any 
good would come out of it. The medicine should never be 
continued when a disease has passed into another stage, for 
instance in typhus, when it passes from the catarrhal into the 
typhoid stage ; in that case other remedies have to be selected 
in accordance with the change of symptoms. 

5. The same remedy should not be continued too long at a 
time, not even in chronic diseases ; even if the dose were in- 
creased the organism would cease to react against it. In such 
case another remedy should be given for a time, as nearly as 
possible in accordance with the symptoms, after which the 
former may again be resorted to. 

6. The smaller the dose the less durable its action. This 
is another reason why the high preparations should be repeated 
more frequently than the lower, particularly in acute diseases. 

Section 108. 

A good deal has been said of homoeopathic aggravations. 
Such aggravations of the symptoms are supposed to occur very 
frequently in consequence of the excessive action of the specific 
remedy. It has been asserted by some that a certain aggrava- 
tion of the symptoms is necessary to excite the counter-action 
of the organism. This is denied by some, and, indeed, justly 
so, for we know from experience that the cure generally takes 
place without such an artificial commotion of the morbid state. 
In the following paragraphs I will communicate the results 
which I have derived from my own observations, and those 
of other physicians, in regard to medicinal aggravation of the 

1. Aggravations do frequently occur after the administra- 
tion of a homopopathic agent ; such aggravations are some- 
times very violent. Gross has observed aggravations af- 
ter Pulsatilla for digestive disorders ; after China for ner- 
vous debility ; after Bryonia for pleuritis ; after Hyosciamus 
for convulsions ; after Crocus for metrorrhagia. Stapf has 
seen aggravations after Spigelia for affections of the eyes ; 
after Rhus for an eruption in the face. Ruckert has seen 
spasms aggravated by Bryonia, and Hartmann cardialgia by 
Pulsatilla. In treating dysentery with Colocynthis, Wolf ob- 
served that the number of evacuations first increased for 


several hours. Dupre-Deloire saw an aggravation of the 
symptoms after the exhibition of Sulphur for haemorrhoidal 
colic ; the aggravation lasted about an hour, when the pain dis- 
appeared. Rummel speaks of an aggravation produced by 
smelling of Bryonia. Schindler saw .an aggravation of head- 
ache and prosopalgia after the use of Belladonna. I have fre- 
quently seen such aggravations, particularly in neuralgic af- 
fections. Aggravations have frequently been observed after 
the higher attenuations, a fact which has given rise to the 
opinion, that those attenuations are not sufficiently powerful to 
excite the curative reaction of the organism. This may be 
true in some instances. Credible practitioners, on the other 
hand, assert that the most dangerous aggravations take place 
from large doses. Kopp relates a case of haemoptoe where a 
daily dose of the tincture of Aconite aggravated the complaint 
very much, which was afterwards cured with the eighteenth 
potency of the same remedy. Kopp likewise relates that the 
sixth attenuation of Stannum proved useful where the third 
aggravated the disease. In a case of laryngeal phthisis re- 
lated by Schrcen, a lower attenuation of Spongia produced an 
almost fatal aggravation of the symptoms. Such and similar 
results have determined me to be exceedingly cautious in the 
selection of a remedy, and to employ the higher attenuations in 
all erethic diseases of delicate and important organs, in in- 
flammations of the brain, heart, lungs and stomach, in active 
arterial haemorrhage, etc. 

2. It frequently occurs that new symptoms set in after the 
exhibition of a medicine. These symptoms are frequently 
mistaken for a homoeopathic aggravation. Hirsch has seen 
haemoptoe set in in phthisis after the exhibition of Phosphorus. 
Griesselich tells us that the exhibition of Nux vomica for tooth- 
ache was followed by oppression of the stomach, bloatedness, 
nausea, dullness of the head and vertigo. He likewise men- 
tions a number of new symptoms, as having made their ap- 
pearance after the administration of Arsenic and Sulphur. 
Hering has seen bilious vomiting supervene after giving 
Arsenic for black-blue itch-pustules. Werber and Elwert 
likewise mention a number of new symptoms succeeding the 
use of homoeopathic remedies. 

The appearance of new symptoms shows that the organ- 
ism has been acted upon, and invites the physician to renewed 
attention. Sometimes weariness and drowsiness set in, and a 
little sleep is followed by the restoration of health. In other 
cases there is an increased exhalation from the skin, and an 
augmented secretion of urine. Sometimes we are told by the 


patient and his attendants that the medicine has had no effect ; 
but upon careful inquiry, we find that it has had an effect. 
Very frequently the patients experience a drawing and creep- 
ing through the limbs, particularly through the affected parts, or 
they feel a dullness and pain in the head, vertigo, itching of the 
skin, and great weariness, with a sensation as if bruised. 
Organs at a distance from the real seat of the disease are 
sometimes sympathetically affected with more or less vio- 
lence. Phenomena of sympathetic suffering are always de- 
sirable in uncertain cases ; even if they do not lead to a cure, 
they disclose the character of the disease, and enable us to 
select the true curative agent. It requires a good deal of close 
observation to determine whether nothing should be given on 
the appearance of new symptoms, or whether the medicine 
should be repeated or replaced by some other more appropriate 

Section 109. 

Hahnemann has laid much stress on the period of the day 
when the medicine should be taken. His advice is not to 
give the medicines at the time when they manifest their primary 
effects. I have frequently found that Belladonna, Pulsatilla, 
and Chamomilla, disturb the sleep if taken in the evening, and 
that Nux vomica acts best when taken shortly before bed 
time. In urgent cases the medicine has, of course, to be given 
on the spot. 

According to Hahnemann, the early morning is the best 
time for taking the medicine. It is true that the sensitiveness 
of the organism is greatest in the morning. But the action of 
the medicine is so easily disturbed in the daytime by heteroge- 
neous influences, that I prefer giving the medicine at night. 

It has been asked whether, in remittent diseases, the medi- 
cine should be given before, during, or after the paroxysm. I 
am satisfied that the medicine may be taken at any time, even 
during the occurrence of the paroxysm, and that at such a 
time the susceptibility of the organism to the action of medi- 
cine is greatest. No one would hesitate to exhibit a remedy 
during the most violent attack of cholera, profuse haemorrhage, 
or during a convulsive paroxysm. Griesselich thinks, that in 
dysentery the remedy should be given after every evacuation, 
and in whooping-cough, after every paroxysm of cough. I 
have frequently found this advice useful, and have, likewise, 
followed it in fever and ague, where I give one dose two hours 
previous to, and another dose of the same remedy two hours 
after the paroxysm, giving the second dose a little stronger, on 


account of the exhausted condition of the organism. In men- 
strual colic, several doses of the suitable remedy should be 
given during the precursory symptoms, and should likewise 
be continuecTduring the paroxysm. Homoeopathic remedies 
may likewise be given during the catamenia ; it is only vio- 
lent enanthiopathic and cathartic medicines that should be 
avoided at such a period. I ought, however, to observe, that 
the female organism is more sensitive during the catamenia, 
and therefore requires smaller doses at such a time. In chronic 
ailments of the vegetative system, where larger doses are 
required, it is therefore expedient to postpone the exhibition of 
the medicine until the cessation of the menstrual flow. 

Section 110. 

I will devote this chapter to a few remarks on palliative 

From time immemorial it has been customary to combine 
the curative and palliative treatment, and to attend to the pal- 
liation of the symptoms alone if a cure was impossible. None 
but unfeeling men can condemn that proceeding. There was 
a time when incurable syphilitic patients were destroyed by 
artificial means, or when patients attacked with hydrophobia, 
were suffered to die of a gradual loss of blood. It is reported 
of Napoleon, that on his retreat from Egypt he caused the 
sick who remained behind in the hospitals to be killed by 
poison, in order to save them from the cruelty of the pursuing 
enemy. The humane physician cannot imitate such exam- 
ples. But all will agree, that we are bound to mitigate the 
sufferings of our patients if a cure be no longer possible. We 
ought to guard, however, against the frequently pernicious 
error of prescribing a remedy for a single troublesome symp- 
tom at the expense of the general treatment. Such errors are, 
for instance, the suppression of a salutary diarrhoea, or of an 
habitual sweat of the feet by means of astringent local appli- 
cations, the violent arrest of a hsemorrhoidal discharge, the 
desiccation of old ulcers on the feet by means of lead-ointments 
or washes, or the suppression of herpes by similar means. 
Even recently, I was called to a young lady who had been 
affected with herpes, and completely lost the enamel of her 
teeth in consequence of the violent suppression of herpes by 
some ointment, probably a mercurial ointment. The applica- 
tion of leeches, in debilitated individuals, for the purpose of 
relieving the pain attendant upon some local venous inflam- 
mation, is an unpardonable offence ; relief if, indeed, obtained 


momentarily, but the distress is so much greater afterwards. 
It is still more inexcusable to relieve pain by opium which is 
not suitable to the general condition of the patient. Some- 
times opium is given for sleeplessness, or to relieve violent 
pain, and removes the whole disease, if the drug happen to 
be homoeopathic to the symptoms. In other cases, the first 
dose of opium procures a feeling of blissful quiet. The pa- 
tient expresses his gratitude for the refreshing sleep which the 
opium had procured him. The physician flatters himself 
with the deceptive hope of having found the specific remedy. 
He gives another dose of opium, but soon finds that the dose 
has to be increased. The patient is tormented by fancies 
which do not allow him any rest. He tosses about in his bed, 
feels sleepy but cannot sleep, starts up as in affright after a 
short slumber, and finally sinks into a sort of stupor, which 
continues even in the daytime, and is accompanied with an 
indescribable feeling of weariness and prostration. Besides 
this, other disagreeable symptoms make their appearance, con- 
stipation for instance, for which new remedies have to be pre- 
scribed. If the patient's vitality do not succumb under such 
conflicting influences, and he finally recover, it will take him a 
long lime to get rid of the consequences of such unwise treat- 
ment. In the homoeopathic method of treatment, a remedy is 
not given for one symptom exclusively, but for all the symp- 
toms collectively. Remedies chosen in accordance with the 
totality of the symptoms, sometimes palliate merely, particu- 
larly in cases which prove incurable ; but such palliatives can 
be repeated without prejudice ; on the contrary, the patient's 
distress will be relieved by them. My friend and neighbor, 
Dr. Glasor, lost, several years previous, his only boy, with 
inflammation of the brain, and subsequent effusion. There 
was no hope of saving the child, but it was important to mod- 
erate the convulsions. This was accomplished by means of 
small doses of Belladonna, under the influence of which the 
child died, apparently without much suffering. In a case of 
incurable cancer of the womb, 1 have afforded more relief 
with small and repeated doses of Pulsatilla, Secale cornutum, 
and Laurocerasus, than could have been accomplished by 
means of opium. Homoeopathic palliatives are vastly supe- 
rior to the usual antipathic anodynes. 

There are many other palliatives which ought not to be 
neglected, although they do not come under the appellation of 
homoeopathic remedies. Such palliatives are the inhalation of 
the vapors of warm water, to relieve the troublesome dry cough 
of patients affected with tuberculous phthisis ; warm fomenta- 


tions of the chest in spasms of the respiratory organs ; appli- 
cations of cold water, snow, or ice to the head, in incipient or 
fully developed encephalitis ; frictions with dry flannel on limbs 
suffering with rheumatism ; frictions with warm oil in cases of 
acute rheumatism and ascites ; injections of water or milk, 
water and oil, in cases of violent constipation ; warm baths in 
a number of cases ; hand and foot baths in congestion of blood 
to the upper parts ; sinapisms and horse-radish plasters to the 
calves in violent delirium ; the lancing of the gums when con- 
vulsions threaten to set in in consequence of the difficulty which 
the tooth encounters in rupturing the gums ; the introduction 
of the vapor of warm milk into the violently inflamed and sup- 
purating ear ; the use of warm gargles in cases of inflammation 
of the uvula or tonsils with accumulation of mucus in the pos- 
terior parts of the buccal cavity ; warm poultices to abscesses, 
in order to hasten the process of suppuration ; carrot-poultices 
to painful cancerous ulcers ; the application of a plaster of wax 
and tallow to open abscesses, or of brandy and water to bed- 
sores that threaten to become gangrenous, or of oil and the 
yolk of an egg when such sores are inflamed and painful. A 
physician who signs himself R., in Thorer's Practical Commu- 
nications, Vol. III., p. 200, gave Lachesis internally in the case 
of a man who had been bitten by a viper, and had fresh cab- 
bage-leaves applied to the wound. Any palliative which does 
not interfere with the general curative treatment, and is known 
to relieve suffering, ought to be and will be used by physicians 
who are not blinded by party spirit or sectarianism, and value 
the consciousness of having been instrumental in mitigating 
the sufferings of their fellow men. 

Section 111. 

Patients tinder treatment, must regulate their diet accord- 

The most violent opponents of the specific healing art are 
willing to admit that the author of homoeopathy has shown 
the necessity of regulating the diet of our patients. They go, 
however, too far, in asserting that all the good that homoeopa- 
thy has ever accomplished, is to be attributed to the rigorous 
diet which homoeopathic patients are directed to pursue. Of 
course, if a man have lost his health by excessive eating and 
drinking, and have not ruined his constitution, the best and 
safest way to restore it, is, by subjecting himself to a proper 

Hahnemann's first dietetic rules were exceedingly rigorous. 


He assumed that an individual under treatment must be re- 
stricted to the use of only those things which are purely and 
absolutely nutritious. Hence every thing which has any medi- 
cinal action, such as asparagus, celery, and parsley, which pro- 
mote the secretion of urine ; onions, which favor the exhalation 
from the skin ; caroway, which has some narcotic properties, 
etc., was strictly forbidden. Coffee, tea, wine, brandy, spices, 
acids, pork, water-birds, young meat, Avere likewise interdicted. 
The homoeopathic diet was not only very hard, but even incon- 

It is true, that a mode of life which is carefully regulated 
according to Hahnemann's instructions, increases the suscepti- 
bility of the organism to medicinal action to a high degree. 
But it is not without some disadvantage. The irritability of 
the organism frequently becomes so excessive that the hetero- 
geneous influences with which we are unavoidably surrounded, 
affect the organism very painfully. The sense of smell be- 
comes so acute, that the perfume of a flower, the smoke of a 
cigar, the odor emanating from an old book, are offensive. 
Moreover, the sudden and complete deprivation of stimulants 
to which the organism had been accustomed for years, is inju- 
rious. An old man, who has been in the habit of drinking 
wine or a little brandy every day of his life, cannot be deprived 
of it without feeling weak and exhausted. Why should a 
little wine or brandy be more injurious than smoking, which is 
allowed, to some extent, by all homoeopathic physicians ? 

Eight years ago, I took charge of an old man who had been 
suffering for a long time past with cardialgia and other symptoms 
of derangement of the digestive organs, and resorted to homoeo- 
pathy in despair. I restricted him to the usual rigorous diet. 
After he had been under treatment eight days, he was much 
improved. On one day I visited him when he was taking his 
supper, which consisted of bread and butter, Bologne-sausage, 
and half a bottle of wine. When I expressed my astonishment 
at this transgression of our dietetic rules, he replied : This has 
been my supper for thirty years, and will be ever after. He 
recovered entirely, in spite of his wine and sausage. . Widn- 
tnann observes very correctly, that the action of homoeopathic 
medicines is too certain to be easily disturbed by a slight die- 
tetic transgression. On the other hand, it would be foolish to 
neglect the diet entirely ; but all fastidious and pedantic observ- 
ance of our dietetic rules is unnecessary. 

Section 112. 

In acute diseases it is important to keep a rigorous diet. 
Patients do not care much about nourishment in those dis- 


eases, and find it therefore very easy to comply with the 
strictest dietetic rules. Coffee, tea, wine, spices, and any 
thing that has medicinal properties, have to be avoided. 
Meat can scarcely ever be allowed. Barley and oatmeal 
gruel, which has been recommended by Hippocrates much 
too generally, is not always suitable, particularly in gastric af- 
fections where slimy and nutritious substances lie heavy on the 
stomach. The old rule, sequere naturam, is the best in acute 
maladies. If there be an aversion to food, let the patient do 
without it until he feels a desire for it. This rule is likewise 
applicable to beverages. Nothing is more cruel than to let a 
patient suffer thirst. Asclepiades denies fever-patients any 
kind of drink, and will not even allow them to rinse their 
mouths. Ancient practitioners generally would not allow 
drink until the temples became moist and the patient com- 
menced to perspire. Afterwards when the maxim prevailed, 
" aut bibere aut mori" patients were tortured with drink in 
order to dilute the humors and to promote the critical secre- 
tions. Neither extreme is proper. Some people still dread 
the cold water, and deny patients the use of it as a drink. 
And yet cold water is the most refreshing and most useful 
drink, and is preferable to any artificial beverage. It is only 
in inflammations of internal organs, of the throat, lungs, 
stomach, intestinal canal, that cold water might prove hurtful 
by its contractive property. Nevertheless it may even be al- 
lowed in such diseases, provided the patients will take it by 
the spoonful, and will keep it in the mouth until its coldness 
shall have abated. It may be made palatable by mixing with 
it a little raspberry, cherry, or mulberry syrup. Water acidu- 
lated with vinegar can scarcely ever be allowed in acute dis- 
eases, inasmuch as vinegar counteracts many of our medicines. 
In acute fevers where the tongue and lips are parched, and the 
teeth have become black, the patient, if he should crave 
something refreshing, may take a teaspoonful of a mixture of 
orgeat and the juice of cherries, mulberries or sweet oranges ; 
this composition is exceedingly refreshing, and does not coun- 
teract the medicine. Lemonade may be allowed in some 
cases. In diseases of long duration the patient ought to be 
allowed various beverages, lest he should get tired of using the 
same beverage all the time. There are many kinds of plea- 
sant drinks which the patient may be allowed, such as a de- 
coction of dried apples or peaches, a lemonade prepared of 
sweet oranges or of the recently expressed juice of ripe grapes, 
a decoction of dried cherries or plums, a simple panado. or- 
geat, buttermilk, water and milk, etc. Among the lower 


classes there is a prejudice that patients ought not to be washed, 
and yet cleanliness is of the utmost importance. It depends 
upon circumstances whether the patient ought to be washed 
with cold or warm water. Fresh air is likewise necessary ; 
it may be let into the sick-room by carefully opening the win- 
dow, or by means of ventilators. Fumigations of any kind 
are to be interdicted. 

Wherever circumstances permit, the patient ought to be 
kept in a high and spacious room, the linen ought to be fre- 
quently changed, and quiet, with careful nursing, ought never 
to be wanting. 

Section 113. 

In chronic diseases there is less occasion for a strict diet. 
However the rules should be precise and adapted to the con- 
dition of the patient. The following general rules will be 
found sufficient. 

1. Alter the patient's mode of life as little as possible, par- 
ticularly in relation to things to which the patient had been 
accustomed for years past. Generally such things have ceased 
to be hurtful. Most patients find it particularly difficult to do 
without coffee, for which it is difficult to find a substitute, par- 
ticularly in persons inclining to costiveness. This is generally 
relieved by coffee, and becomes very troublesome when the 
use of coffee is stopped. Pure milk does not agree with many 
people. Chocolate without spice, which is generally substi- 
tuted for coffee, is apt to occasion bloatedness, a feeling of full- 
ness, and constipation ; moreover it becomes soon disagreeable. 
Coffee made of parched rye, corn, or barley, is too unsavory 
for dainty palates, and not sufficiently stimulating for spoiled 
stomachs. A mixture of corn-coffee and chocolate without 
spice is not very unpleasant. Many patients content them- 
selves with a little broth in the place of coffee. In many 
cases the use of coffee may be continued, but it ought to be 
taken a little weaker than ordinarily. The same may be 
said of brandy and wine ; they ought to be perfectly pure, 
without any admixture of caroway, aroma or sulphur. A 
little pure weak hop-beer may be allowed if the patient be 
used to it. Tea has many medicinal properties, and can only 
be allowed with certain restrictions. Green or black tea may 
be used indiscriminately. Mulder has shown that both kinds 
of tea are of the same plant, and that the difference in color 
arises from the fact that the drying of the darker tea is carried 
on more precipitately. 



Meat should not be forbidden, if it be not otherwise contrary 
to the patient or the disease. Even pork and goose-flesh may- 
be allowed in some cases. Young meat is less nourishing 
than the boiled or roast meat of older animals. Veal-soup oc- 
casions diarrhoea, and mutton-soup costiveness in may cases ; 
the physician will have to allow or forbid either accordingly. 

Perfumes and medicinal tooth-powders have to be discon- 
tinued. Moderate smoking may be allowed, but neither im- 
mediately before nor immediately after taking the medicine. 
Snuff is generally mixed with aromatic substances, and should 
therefore not be used. 

If infants at the breast are under treatment, their nurses 
have to observe a most rigorous diet, on- account of the milk 
being so easily affected by heterogeneous substances. In other 
respects, patients should be very regular in all their habits, 
washing and sleeping, exercise, warm or light clothing, etc. 

2. The diet which is once prescribed for the patient should 
never be departed from. The patient should never be allowed 
to take any thing by way of exception. 

3. Every thing which has a tendency to prolong or excite 
the disease, should be carefully removed from the patient's 
presence. Excesses of any kind have to be avoided. What- 
ever disagrees with the patient should likewise be avoided. 
Fat and salt meat, pork and goose-flesh, should not be tasted 
by any who are treated for cutaneous eruptions. 

4. Whatever interferes with the action of a remedy has to 
be avoided. Acids, for instance, neutralize Aconite, Kali, Na- 
trum, and Ammonium. The action of Belladonna is increased 
by vinegar, that of Sepia by milk (according to Dufresne), that 
of Alumina by potatoes, etc. Whenever a particular organ is 
to be acted upon, every kind of nourishment which has a spe- 
cific influence upon the same organ, should be omitted. As- 
paragus, parsley, and celery, are to be prohibited during the 
use of diuretics. 


The publication of this number of the Homoeopathic Examine? 
has been delayed for an unusual length of time. The object of this 
delay has been to enable me to complete the translation of Rau's Or- 
ganon, and to lay it before the profession as a welcome and useful ad- 
dition to our American homoeopathic literature. The essay " on the 
present internal condition of the Homoeopathic School," will be sent to 
all the subscribers of the Examiner in a few weeks ; it will be printed 
on the same paper and have the same form as the Examiner. The 
publication of Jahr's new work, and my daily professional business, 
have likewise engrossed so much of my time, that scarcely any time 
was left for Rau. 

I shall not examine the merits of Rau's work in this note. That ex- 
amination will be attended to in my essay. In general terms I will 
here state, however, that I consider Rau's work a valuable production, 
embodying much thought, much useful information, and a spiritof deep 
and independent research, which does honor to the author, and marks 
him as one of the most cultivated thinkers of our school, and a physi- 
cian of sound heart and judgment. When Rau's work first appeared, 
a hue and cry was raised against it by a few timid and somewhat con- 
ceited men, who considered themselves the infallible representatives 
of pure homoeopathy. But the time is fast approaching when Rau's 
effort to secure homoeopathy an independent position in the realm of 
science, will be gratefully acknowledged. I am free to say, however, 
that I do not approve of all of Rau's conclusions ; at the same time, I 
honor his manly independence, and the philosophical character of his 

Rau's work is an excellent publication to be placed in the hands of 
Alloeopathic physicians who wish to make themselves acquainted with 
the principles of homoeopathy. It may be considered a transition-link be- 
tween the ordinary text-books on Medicine and Hahnemann's Organon. 
Rau's Organon is a philosophical and argumentative exposition of the 
principles and practice of homoeopathy. If such a man as Rau were 
living in the midst of us, we would most probably avail ourselves with 
eagerness of the opportunity of discussing with him the great question 
of Medical Reform. Why then should we not read his works with 
becoming attention ? All thinking members of the Profession will, and 
will be amply rewarded for their trouble, by the suggestive richness of 
Rau's thoughtful and comprehensive mind. 


New-York, 95 Spring-street. 


The Author's Preface, 


Object of medicine. .... 

Party-spirit in medicine, . 

Value of systems, .... 

Character of Hippocratic medicine, 

Empirical treatment of disease, its difficulty, 

Character of ancient medicine, 

Idealism in medicine, .... 

Analytical method, 

Iatro-physical, or mechanical school, 

Chemiatrical, or chemical school, » 

Solidism and humoralism, 

Dynamic school, .... 

Brown's theory, .... 

Rasori's theory, • 

Pathological alteration of organs, 

On the alteration of humors, 

Changes in the blood, , 

Classification of the phenomena of life under three heads : forma 

tion (reproduction), motion, sensation, ... 
Remarks on rational treatment ; is the homoeopathic treatment 

rational ? ...... 

Fixed ideas of physicians, ..... 

Danger of curative treatment, .... 

Antipathic, or enanthiopathic method, .... 

Revulsive method, ...... 

Specific method, ....... 

Is the study of the old school system of treatment rendered unne 

cessary by a knowledge of the homoeopathic treatment ? 
What is a system 1 ...... 

Characteristics of a true system : 

(1.) The principle which unites the different parts of a doc 

trine must be true, . 

(2.) The different parts of the system must likewise be true, 
The materials which Hahnemann has made use of in his system 

have only been drawn from two fields of science, nosography 

and pharmacodynamics, ...... 

Uncertainty of medicine, ...... 
















Self-preservation is the first and most remarkable manifestation of 
individual life, . . . . . . .37 

The tendency of the individual life to preserve its individuality, 

manifests itself by opposing the surrounding influences of nature, 37 
The mode in which the individual life opposes the surrounding in- 
fluences of nature, depends upon the more or less perfect organ- 
ization of the individual, . . . . . .38 

Health is the integral action of the vital functions, which has for 

its object the preservation of the individual, . . .39 

The principal condition of health is a normal state of the organism, 39 
Disease is an abnormal vital process which does not correspond to 
the true development of the individual, . . . .40 

Disease results from the cessation of the normal state of the vital 
activity, . . . . . . - .42 

The different forms of disease are determined by the laws which 
control the manifestations of vitality, . . . .45 

Every disease is originally local, ..... 49 

It is expedient to designate by particular names certain morbid 

conditions which are characterized by particular symptoms, . 52 
Hahnemann's opinion of disease ..... 58 

Psora, syphilis, sycosis, . . . . . .58 

Hahnemann's psora-doctrine does not affect the homoeopathic doc- 
trine, . . . . . . . .63 

Danger of the external treatment of cutaneous diseases, . 64 

Examination of Hahnemann's opinions on syphilitic infection, . 67 
Character of sycosic excrescences, .... 68 

Classification of gonorrhoea, . - . . . .69 

On latent syphilis, . . . . . . 69, 70 

Hahnemann's reasons for restricting the origin of chronic maladies 
to psora, syphilis, and sycosis, . . . . .71 

Good results of the psora-doctrine, .... 74 

The division of diseases into acute and chronic is of very little use 
in practice, . . . . . . . .75 

Disease becomes manifest by reaction, the same as life, . 76 

The reaction of the organism against external influences is of dif- 
ferent kinds, ....... 78 

Different kinds of reaction on the part of the organism against ex- 
ternal influences : 

(1.) Direct and entire opposition to those influences, . . 79 

(2.) Reactions differing from those of the vital force in its 

normal state. . . . . . .81 

(3.) Reactions that are in polaric opposition to the action of 

noxious agents, . . . . . . 81 

The continuance of the morbid condition depends — 

(a) Upon a continuance of the external morbific agents, . 81 

(6) Upon the continuance of the internal cause, . . 83 

Division of diseases into dynamic and somatic, . . .83 

The dynamic alteration, or violation of the vital force, may be of 

various kinds, . . . . , . .83 

The continuance of a disease frequently depends upon abnormal 
local changes, . . . . . . .84 


Another cause of the continuance of a disease is the absence of a 
dynamic resistance, . . . . . .85 

Difference between reaction, counter-action, and curative action, . 89 
A crisis is a true vital process, . . . . .89 

Different kinds of crisis, . . . . . . , 90 


The safety of the treatment depends upon a correct diagnosis, . 92 
Object of diagnosis, ...... 92 

The means of diagnosing are : 

(1.) Etiology, or the doctrine of morbific causes, . . 93 

(2.) Symptomatology, or the doctrine of the symptoms, . 96 

Symptoms are the external, objective manifestation of the morbid 

process which is taking place in the internal organism, . . 99 

To form a correct diagnosis we have to employ every available 
and requisite means, . . . . . .99 

It is of especial importance — 

(1.) To ascertain the influences by which the disease has 

been occasioned, . . . . . .99 

(2.) To observe the ruling character or disposition of disease ; 

11 genius of disease," ..... 102 

(3.) To know the history of the case, . . . 102 

(4.) To notice the influences which are injurious or advan- 
tageous to the patient, ..... 103 

(5.) To appreciate the existing symptoms, . . . 104 

(6.) To institute a correct examination of the patient, . 104 

Observations on Hahnemann's mode of examining the patient, . 105 
In examining the patient we have to consider : 

(1.) The condition of the sensitive sphere, . . . 106 

(2.) The symptoms of the irritable sphere, . . . 108 

(3.) The symptoms of the reproductive system, . . 109 

(a) Digestive functions, .... 109 

(b) Respiration, ...... 109 

(c) Abnormal metamorphosis generally, . . 110 
Essential and non-essential symptoms, .... 112 
The highest object of therapeutics is to remove every symptom of 

the disease, . . . . . . . .113 

The science of therapeutics is based upon a knowledge of the ob- 
ject of cure, and of the remedial agents, .... 114 

Causes of the incompleteness of our knowledge of the effects of 
drugs, . . . . . . . .116 

Observations on the mixing of drugs, . . . .118 

Method of preparing homoeopathic remedies, . . .120 

The principal object in the preparation of homoeopathic remedies, 
is to divide and dilute them, ..... 120 

It is an undeniable fact that the medicinal virtues of drugs are de- 
veloped by dividing or breaking up their substance, . . 121 
Dynamization, ....... 123 

It is important that the quality of our remedies should not be sub- 
ject to changes, ....... 126 

The proving of drugs upon the healthy is of the utmost importance, 129 
The provings have to be frequently repeated, . . . 130 

The provings must be instituted on males and females, . 130 


The provings must be instituted on persons of different ages, . 130 

It is advisable to observe the temperaments and dispositions of the 
probers, ••••.... 130 

The effects of drugs have to be observed in all possible conditions 
and circumstances, ..... . 131 

Provers of drugs must enjoy good health at the time of proving, ! 131 
The action of the drug must be as little as possible disturbed by 
heterogeneous influences, .... , 131 

Drugs must be taken in sufficiently large doses to make their pri- 
mary effects distinctly perceptible, . . . 132 
To have a perfect knowledge of the effects of drugs, we must be 
acquainted with the dynamic alteration produced by them in the 
organism, ...... .132 

The order in which the symptoms make their appearance should 
be particularly noticed, ...... 132 

It is equally important to observe the effects which medicines have 
on particular organs, ...... 133 

It is of importance to investigate the mode in which medicines act 
dynamically, ....... 133 

We do not yet possess a true science of pharmacodynamics. . 134 

Rules for obtaining a certainty in regard to the effects of drugs, . 134 
If we are well acquainted with the primary effects of drugs upon 
the healthy, we are able to determine the range and nature of 
their curative powers, ...... 136 

The object of treatment is to completely remove the disease, . 137 
First general therapeutic rule — remove all morbific influences, . 138 
Internal morbific influences ought likewise to be removed, . 139 

Second therapeutic rule — remove the abnormal dynamic conditions, 143 
Causes which make the Galenian treatment of disease unsafe and 
even dangerous, ....... 144 

Natural method of treating diseases, .... 146 

The principle " similia similibus " has been followed in practice 
from time immemorial, ...... 149 

Select a remedy which is capable of producing in the healthy or- 
ganism an affection similar to the disease which is to be cured, 151 
Objections which have been raised against the homoeopathic law as 
a principle, . . . . . . .152 

In homoeopathic treatment we require to exhibit agents the effects 
of which upon the healthy organism are as similar as possible to 
the character of the disease, ..... 154 

Difficulty of treating diseases by the mere symptoms, . . 155 

The curative efforts of nature ought to be assisted, not arrested , 156 
What is to be done if the pathological character of the disease be 
unknown, ........ 160 

Isopathic method, ...... . 163 

A lew remarks on the treatment of acute and chronic diseases, . 165 
Treatment of inflammatory diseases, .... 166 

What is inflammation 1 ..... . 168 

When is bleeding proper ? . . . . . 173 

Treatment of mental diseases, . 174 

Treatment of complicated diseases, . . . 175 

Treatment to be pursued in cases of swoons, apparent death, . 176 
Derivative method, ...... 177 

Magnitude of the dose, . . . . . .178 



When the organism is exceedingly sensitive smaller doses are 
required, ........ 179 

The following points have to be considered in determining the dose : 

Age, 179 

Constitution, ...... 179 

Nature of the disease, ..... 179 

Seat of the disease, ..... 181 

Inherent strength of the medicine, .... 182 

Affinity of medicines for single organs. . . 182 

Idiosyncracies, ...... 182 

In some cases small doses have no effect, •• . 182 

Repetition of the dose, ...... 183 

On homoeopathic aggravations, ..... 185 

When should the medicine be taken 1 188 

Palliative treatment, ...... 188 

Diet, . . . . . . . . 190